UNIVERSITY OF SOUTHERN MAINE
REGISTRAR'S OFFICE
37 COLLEGE AVENUE
GORHAM, ME 04038


                          

 

TODAYS DATE :____________________________

COMPLETE THIS FORM AND OBTAIN THE REQUIRED SIGNATURES.  RETURN IT TO THE REGISTRAR'S OFFICE

ON THE GORHAM CAMPUS OR THE ENROLLMENT SERVICES OFFICE ON THE PORTLAND CAMPUS

FAX: 207-780-5517


WITH THIS FORM I AM:

 

 

___ DECLARING A MINOR                                   ___ ADDING A SECOND MINOR                                  ___ DROPPING A MINOR(S)


1. STUDENT'S NAME (Please Print)

 

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2. I. D. NUMBER

 

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3. CURRENT MAJOR

 

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4. EFFECTIVE DATE

____ FALL ___ SPRING ___ SUMMER

 

5. NEW MINOR

 

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SIGNATURE OF CURRENT ADVISOR

 

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SIGNATURE OF NEW DEPARTMENT CHAIR

 

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02/2007