Declaration or Change of Undergraduate Major, Minor, Honors, or Degree Program

Submit in person to: Mail or fax to:

Student Services Center Office of the University Registrar
Tresidder Memorial Union, 2nd Floor Stanford University
Monday - Friday, 9 a.m. - 5 p.m. 630 Serra Street, Suite 120
http://helpsu.stanford.edu/?pcat=ssc Stanford, CA 94305-6032
Please type or print Fax: (650) 725-7248

Last or Family Name First Middle

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Stanford Student Number Email Address Phone
Complete this form only if declaring an Individually Designed Major, Interdisciplinary Honors, or changing degree
program after application to graduate deadline for your graduation term. All other transactions can be completed
through Axess. Note that in Axess, a new major must be added before original major is dropped.
  I have applied to graduate in _____________ Quarter in Academic Year 20____-20____.
  I have not applied to graduate.

I am making the following changes to my undergraduate degree program:

  Declaring a major for the first time. My major will be_________________________________________________
Add Drop (check all that apply)
   major _ ________________________________________________
   major _ ________________________________________________
  secondary major _ ________________________________________
  minor _ _________________________________ to/from this major ____________________________
  departmental honors to/from this major _______________________
  field or subplan ___________________________ to/from this major ____________________________
  Interdisciplinary Honors Program in:
  Education   Ethics in Society   Feminist Studies
  Latin American Studies   International Security Studies   Science, Technology, and Society
  Environmental Science, Technology, and Policy       Democracy, Development and the Rule of Law
  Individually Designed Major. Title of IDM:________________________________________________________
  Changing a single Bachelor of Arts and Science (B.A.S.) degree to dual bachelor's degrees, i.e., a Bachelor of Arts
(B.A.) and a Bachelor of Science (B.S.)*
  Changing dual bachelor's degrees, i.e., a Bachelor of Arts (B.A.) and a Bachelor of Science (B.S.), to a single
Bachelor of Arts and Science (B.A.S.) degree*

When the change(s) above is/are made, what will your undergraduate degree plans be?
  B.A.      B.S.       B.A.S.
With the following majors ________________________________________________________________________
  Secondary major ______________________________    Minor _ ___________________________________
  Departmental honors in this major _ _______________    Interdisciplinary honors _______________________
Signatures

Student Signature Date

Departmental Administrator Signature Print Name Date

Departmental Administrator Signature (if applicable) Print Name Date

Registrar use only

Approval Signature Print Name Date
09/2010