Change of Program

Student Information

Student ID Number:

Example: C00123456

MyCCTC Email Address

Example: dduck@cctech.edu

Phone Number

Legal First Name:

Legal Last Name

Current Program/Concentration

Desired Program/Concentration

Mailing Address:

Mailing City:

State

Zip Code

Program Change Information

For what start term are you requesting this change? Please note that the term for which your program is changed may be decided by your registration or financial aid status.

Reason for Program Change:

Select all that apply. If on a computer, hold "Ctrl" and click to select more than one.

If "Other" is selected, please explain:

If you would like to provide any other information about the reason for your request, please do so here. Admissions staff may connect you with any appropriate resources or advising.

Are you currently a Dual Enrollment student?

YesNo

Please enter your state issued ID information.

ID State

ID Type

ID Number

ID Issue Date

Example: MM/DD/YY

ID Expiration Date

Example: MM/DD/YY

Are you currently receiving VA benefits?

YesNo

Have you received counseling from CCTC’s VA Certifying Official?

YesNo

Are you a WIA or TAA recipient? (Please be advised that you will be required to contact your caseworker to make sure your desired program of study will be paid before a Change of Program can be completed).

YesNo

Program changes may require approval from financial aid. Additional information may also be required. Monitor your MyCCTC email for program change confirmation.

By clicking the "Complete" button below, I certify I am the student requesting the change and the information submitted on this form is accurate and complete.

CCTC Programs