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MINOR PROGRAM FORM

(This form should be submitted to your college office)
College: ___________________________________ Major: __________________________
  Minor: __________________________
Student’s Name _________________________________________________________________
Last First Middle Last 4 digits of Student I.D. #

Local Address __________________________________________________________________
Number and Street City State Zip

Telephone Number _______________________
Expected Quarter/Year of Graduation ________
Email Address: _________________________________________________________
Have you filed a degree application in your college office? ____ Yes _____ No
Course Name and Number Hours Final Grade
________________________________________________ _______ ___________
________________________________________________ _______ ___________
________________________________________________ _______ ___________
________________________________________________ _______ ___________
________________________________________________ _______ ___________
________________________________________________ _______ ___________
Total Hours _______


Original ___

______________________________________
Revision ___ Signature of Faculty Advisor
______________________________________
Date