Higher Education Change of Status Form CHange of Status form higher education programs "*" indicates required fields Student InformationLegal Name* First Middle Last Email* Phone*Which type of Program are you enrolled in?* Full Time/ Degree Program Short-Term or Continuing Education Program Full-Time/ Degree Program Course InformationSelect Your Full-Time Program* Automotive Technology AST Advanced Welding Welding Technology Dental Assistant Dental Hygiene AST Medical Assistant Practical Nursing Veterinary Technology AST Short-term / Continuing Education Course InformationSelect Your Short-Term or Continuing Ed Program* Machinist/CNC Operator Training Program Basic Industrial Maintenance Commercial Truck Driving (CDL) Training – Class A Commercial Truck Driving (CDL) Training – Class B HVAC EPA Certification Expanded Function Dental Assistant Phlebotomy Emissions Inspector Certification Course Vehicle Safety Inspection Certification – Category 1 and 2 Vehicle Safety Inspection Certification – Category 1 OR 2 Vehicle Safety Inspection Certification – Category 3 Basic Welding Electric Arc Welding Mig Welding TIG Welding Who is completing the form?Name* First Last Reason for Status Change* Withdraw from Program Change a Program/Level Add/Drop a Course Explanation of Status ChangeEffective Date of Change* MM slash DD slash YYYY Phone number where a representative can reach you:*Best time to callI acknowledge I have discussed my change of status with my instructor, advisor, and/or success coach.* Yes No I acknowledge I have discussed my change of status with financial aid and the business office and understand how this change may impact me financially.* Yes No EmailThis field is for validation purposes and should be left unchanged.
