Application to Change Program

The University of Vermont
College of Education and Social Services
Student Services Office
85 South Prospect Street
528 Waterman Building
Burlington, VT 05405

Please fill in the following information:

Applicant Information
Name
ID#
Date
Local Address
Permanent Address
E-Mail Address
Local Phone Number
Permanent Phone Number
Present Program

Bachelor of Science in Education
Check appropriate program. Select Major Concentration, Major, Minor if applicable.
Art Education (PreK-12)
Elementary Education (K-6)	Major Concentration
Middle Level Education (5-9)
Music Education (PreK-12) (audition required)
Physical Education (PreK-12)	Major Concentration
Secondary Education (7-12)	Major

Bachelor of Science
Check appropriate program. Select Major Concentration if applicable.
Early Childhood Education (PreK-3)	Major Concentration
Early Childhood Special Education	Major Concentration
Human Development & Family Studies
Social Work

Please provide your rationale below for requesting a change of program. The rationale should not exceed one typed page. Be clear and concise and be certain to use correct grammar and present the information as professionally as possible. The rationale should provide the department with the information necessary to make an informed decision.