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Request Change of Status
Before completing this form, review Program Requirements and course in the Pathways College Catalog. The Pathways College Catalog can be found on the website
pathwayscollege.org
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Email
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Your email
First and Last Name
*
Your answer
Date of Request
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MM
/
DD
/
YYYY
Phone Number
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Your answer
Reason for change of student status:
*
Academic Load
Personal
Medical/Health
Financial
Expulsion
Academic deficiencies
Schedule conflict
Transferring major
Program does not fit needs
Military Deployment
Other
I am requesting to withdrawal from the following program:
Bachelor of Arts in Business Administration
Bachelor of Arts in Liberal Studies
Clear selection
I am requesting to enroll in the following program:
Bachelor of Arts in Business Administration
Bachelor of Arts in Liberal Studies
Clear selection
Please give a short explanation for why you are submitting this request.
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Your answer
Please read, check, and submit:
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By checking this box and submitting this form, I am agreeing that I am signed in to Pathwayscollege.org as myself and that all the information on this form is correct.
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Title: _____________________________________________
Signature: ________________________________________
Date:_________________________
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