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EDU Program Change Form
This form is to approve EDU graduate student changes in concentrations and/or credential programs.
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* Indicates required question
Email address
*
Your answer
Student ID
*
Your answer
Last name
*
Your answer
First name
*
Your answer
I am:
*
The student
Completing on behalf of the student
Effective Term and Year (e.g., Spring 2025)
*
Your answer
CURRENT Concentration:
MS in Education - Teacher Leadership Concentration (Credential Program)
MS in Education - Interdisciplinary Concentration
MS in Education - Special Education Concentration
Clear selection
I am trying to change:
*
Concentration
Credential Program
Content Area
Other:
Required
CHANGE to Concentration:
Requires advisor approval.
Teacher Leadership Concentration (Credential program) <
katie.lewis@dominican.edu
>
Interdisciplinary Concentration <
jennifer.lucko@dominican.edu
>
Special Education Concentration <
elizabeth.truesdell@dominican.edu
>
N/A - Not changing my Concentration
Clear selection
CURRENT Credential program:
Multiple Subject
Single Subject
Education Specialist: Mild/Moderate
Dual - Multiple Subject
Dual - Single Subject
Education Specialist for Credential Holder
N/A - Not enrolled in a Credential program)
Clear selection
CHANGE to Credential:
Requires advisor approval.
Multiple Subject <
katie.lewis@dominican.edu
>
Single Subject <
rebecca.birch@dominican.edu
>
Education Specialist: Mild/Moderate <
elizabeth.truesdell@dominican.edu
>
Dual - Mulitple Subject <
elizabeth.truesdell@dominican.edu
>
Dual - Single Subject <
elizabeth.truesdell@dominican.edu
>
Education Specialist for Credential Holder <
elizabeth.truesdell@dominican.edu
>
N/A - Not enrolled in a Credential program
Clear selection
CURRENT Content Area:
Your answer
CHANGE to Content Area:
Requires Advisor approval.
Your answer
Disclaimer
Please note that depending on the nature of your request, your request may be forwarded to multiple recipients for approval and review prior to being received and processed.
*
This form serves to submit my request only.
It is my responsibility to follow up on the status via Self Service and/or with the appropriate parties involved (e.g., advisor, program director, department chair)
I acknowledge that all requests are subject to deadlines as stated on the Academic Calendar.
Required
E-Signature Consent
*
I give consent to sign this document electronically.
Required
Student Signature
*
Your answer
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