Change of Status Form Change of Status Step 1 of 3 33% Your InformationLegal Name* First Name Middle Initial Last Name Email* Which program are you currently enrolled in?*Full-time / Degree ProgramShort-term or Continuing Education ProgramFull-time / Degree Program Course InformationSelect the Full-time Program*-- Please select an option --ADVANCED MANUFACTURING- Welding Technology- Advanced Welding TechnologyPrecision ManufacturingCONSTRUCTION TECHNOLOGIESCabinetmaking & Wood TechnologyPlumbingCONSUMER SERVICESEarly Childhood EducationVETERINARY SCIENCE- Veterinary Technology Specialized Associate Degree Program (AST)HEALTH CARE / MEDICAL TECHNOLOGIES- Dental Assistant- Dental Hygiene Specialized Associate Degree Program (AST)- Medical AssistantMedical Administrative AssistantSports Medicine/ Rehabilitation Technician- Practical Nursing ProgramTRANSPORTATION TECHNOLOGY- Automotive Technology- Automotive Technology Specialized Associate Degree Program (AST)Short-term / Continuing Education Course InformationSelect the Short-term or Continuing Education Program*-- Please select an option --ADVANCED MANUFACTURING- Basic Welding- Electric Arc Welding- Industrial Mechanical & Maintenance (Mechatronics)- Introduction to Manufacturing- MIG Welding- TIG Welding- Basic Industrial MaintenanceCONSTRUCTION TECHNOLOGY- HVAC-EPA CertificationHEALTH CARE / MEDICAL TECHNOLOGIES- Expanded Function Dental Assistant- Medical Terminology- PhlebotomyTRANSPORTATION TECHNOLOGY- Commercial Truck Driving (CDL) Training - Class A- Commercial Truck Driving (CDL) Training - Class B- Driver Education Training- Emissions Inspector Certification Course- Heavy Equipment Operator- Heavy Equipment Operator & CDL Class A Combo Course-Vehicle Safety Inspection Certification - Category 1 and 2-Vehicle Safety Inspection Certification - Category 1 OR 2- Vehicle Safety Inspection Certification - Category 3 Who is completing the form?* First Last Reason for status change*Leave of AbsenceWithdraw from ProgramChange of Program/LevelAdd/Drop a CourseCourse NameExplanation of status change*Current Class Enrolled*Effective Date of Change* Date Format: MM slash DD slash YYYY Phone number a representative can reach you at*Best time to call*I acknowledge I have discussed my change of status with my instructor, advisor, and/or success coach.* Yes 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 NameThis field is for validation purposes and should be left unchanged.