MAJOR DECLARATION FORM
CLARK COLLEGE REGISTRATION OFFICE 1933 Fort Vancouver Way Vancouver, WA 98663 (360) 992‐2183  (360) 992‐2876 FAX EFFECTIVE QUARTER:  SUMMER  FALL  WINTER  SPRING 20 Print clearly using black or blue ink Date of Birth (MM/DD/YY) Student ID Number Last Name: First Name: Middle Initial: Address: City: State: Zip: Day Phone: Evening Phone: DIRECTIONS Students should declare their major when they begin classes at Clark. Changes to a student’s major should be made in consultation with an advisor. Using the program information on the back of this form, indicate what type of program you intend to complete.  FIRST QUARTER MAJOR DECLARATION TYPE OF DECLARATION:  CHANGE OF MAJOR  DECLARED MAJOR AREA OF STUDY AT CLARK (required): 2 TO 4 DIGIT PROGRAM CODE: GENERAL CREDIT
REQUIREMENTS* (codes on back of form)  WHAT TYPE OF DEGREE OR CERTIFICATE ARE YOU SEEKING? (Check only one) Associate Degrees= ≥90 credits  Associate in Arts (AA) B  Associate in Science Transfer (AST) B CP= >45 credits  Associate in Applied Technology (AAT) G/F  Associate in Applied Science (AAS) G/F CA= ≤45 credits  Associate in Fine Arts Graphic Design (AFAD) B  Associate in Fine Arts Studio Art (AFAS) B CC= less than 20 credits *Please see an advisor for  Certificate of Proficiency (CP) G/F  Certificate of Achievement (CA) G/F  Certificate of Completion (CC) F  High school diploma/GED D specific program requirements.
 No degree or certificate J/L  No degree or certificate‐just taking prerequisite courses to transfer B/PREQ  I HAVE APPLIED FOR A LIMITED ENTRY HEALTH PROGRAM AND/OR TAKING PREREQUISITE COURSES TOWARDS: G Dental Hygiene Medical Assistant Medical Radiography Nursing Pharmacy Technician Phlebotomy  Phlebotomy/NAC  DO YOU PLAN TO TRANSFER TO A 4‐YEAR INSTITUTION?  Yes  No  Already enrolled at another school If yes, to what school do you intend to transfer? Your signature below acknowledges that you have met with an advisor to discuss your major and developed an Educational Plan. You also understand the financial aid eligibility of your program selection. If you are completing your degree or certificate within the next two quarters, please contact the Credential Evaluations office for information on the Program Completion process. STUDENT SIGNATURE: Date Alternate format of this document is available upon request. Please contact Disability Support Services at (360) 992‐2314 or (360) 991‐9901(VP). FOR OFFICAL USE ONLY 
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INTENT: M = F + Transfer DATE STAMP  B  D F = in program  F  G  J  L G = completing prerequisites PROGRAM CODE (F, G, H, J, M): Purp field updated on SM700A (B/M = 12, 90 or F,G = 11, 14, 90) QUARTERLY Stu Plan Attnd field updated on SM4002 (B = 13‐15) PERMANENT ALREADY IN SMS  M YRQ B_______ AA/AFA/AST/DTA‐MRP Degrees B AA Associate in Arts DTA AA AA Associate in Arts Option B AAB AA Associate in Arts Biology DTA/MRP AB AA Addiction Counselor Educ DTA AC AA Business Admin DTA/MRP BMRP AA Business Admin WSUV DTA BAW AA Dental Hygiene EWU DTA DH AA Math Education DTA/MRP AAM AFA Assoc in Fine Arts Graphic Design AFAD AFA Assoc in Fine Arts Studio Art AFAS AST Assoc in Science Transfer TRK1 AST1 (Biol Sci, Chem/Geol, Env/Res Sci, Erth Sci) AST Assoc in Science Transfer TRK2 AST2 (Engr, Comp Sci, Phys, Atmos Sci) AST Bioengr/Chem‐Engr TRK2 MRP BIOE AST Comp/Elect Engr TRK2 MRP CEE AST Other Engineering TRK2 MRP OTRE (Mechanical, Civil, Aeron, Engineering) AAS/AAT Degrees AAS‐Accounting AAS‐Addiction Counselor Education AAS‐Administrative Assistant AAS‐Architectural CADD AAS‐Bakery Management AAT‐Baking/Bakery Management AAS‐Business Administration AAT‐Business Technology Specialist AAT‐Cisco Technologies AAS‐Civil CADD AAS‐Computer Support AAS‐Construction AAT‐Construction AAS‐Dental Hygiene AAS‐Diesel Technologies AAT‐Diesel Technologies AAS‐Early Childhood Education AAS‐T‐Early Childhood Education AAS‐Fitness Trainer AAT‐Industrial Maint. Technologies AAT‐Instrumentation/Control Auto AAS‐Legal Administrative Assistant AAS‐Marketing AAS‐Machining Technologies AAT‐Machining Technologies AAT‐Mechanical Automation AAS‐Mechanical CADD AAT‐Medical Assistant AAS‐Medical Office Technologies AAS‐Medical Radiography AAS‐Merchandising Management AAT‐Microsoft Technologies AAS‐Nursing AAT‐Office Management G/F 505 4371 548 783 8471 8472 502 5171 6441 798 518 606** 6061** 308 775 7751 402 4021 351 768 6332 577 252 808 8081 6331 782 3812 565 358 251 5271 323 5471 AAS‐Paralegal AAT‐Pharmacy Technician Leadership AAS‐Supervisory Management AAS‐Surveying/Geomatics AAT‐T‐TEN Automotive AAT‐Web/Graphic Design AAT‐Web Development AAT‐Welding Technologies 586 3991 545 624 7122 7281 5072 8142 CA/CP Certificate Programs CP‐Accounting Clerk CP‐Addiction Counselor Education CP‐Architectural CADD CP‐Baking CP‐Bakery Management CA‐Baking CP‐Business Administration CA‐Cisco Technician CA‐Cisco Network Administrator CP‐Civil CADD CP‐Computer Support CP‐Construction Technician CA‐Customer Service CA‐Datacenter Technician CP‐Diesel Technician CP‐State ECE Certificate CA‐Flux Core Arc Welding CA‐Front Office Assistant CA‐Gas Metal Arc Welding CA‐Gas Tungsten Arc Welding CP‐Graphic Design CP‐Health Information Assistant CP‐Instrumentation/Control Auto CA‐Instrumentation/Control Auto CP‐Legal Office CP‐Machining Technician CP‐Manual Machining CP‐Mechanical Automation CA‐Mechanical Automation CP‐Medical Assistant CP‐Medical Billing/Coding Specialist CP‐Mechanical CADD CA‐Medical Receptionist CA‐Microsoft Technician CP‐Office Assistant CP‐Office Software Applications CP‐Paralegal CP‐Pharmacy Technician CP‐Phlebotomy/Nursing Assistant CA‐Phlebotomy CP‐Professional Sales CA‐Shielded Metal Arc Welding CP‐Small Business Management CA‐Supervisory Management CP‐T‐TEN Automotive G/F 505A 437B 783A** 847B 847C 847E 502A 644E 644F 798C** 518A 606A** 297E 527F 775A 46EA 814G 553F 814H 814C 731A 529C 633B 633F 577A 808A 808B 633A 633E 381B 313A 782B** 312G 527E 559A 517A 586A 399A 382A** 382E** 252A 814D 257A 545E 712A CP‐Web Design CA‐Web Programming CP‐Welding Technician 524B 507E 814B CC Programs F CC‐ECE Administration 45EM** CC‐Baking I 847M** CC‐Baking II 847N** CC‐Baking III 847O** CC‐Baking IV 847P** CC‐Computer Application I 517M** CC‐Computer Application II 517N** CC‐Computer Application III 517O** CC‐Early Childhood Education I‐BEST 402W** 364M** CC‐Emergency Medical Tech Basic CC‐ECE Family Child Care 44EM** CC‐ECE General 41EM** CC‐Group Fitness Instructor 351M** CC‐ECE Infant‐Toddler Care 42EM** CC‐ECE Initial Certificate 40EM** CC‐Nursing Assistant I‐BEST 329W** CC‐Nursing Assistant 329N** CC‐Office Skills I 559M** 559N** CC‐Office Skills II CC‐Office Skills III 559O** CC‐ECE School‐Age Care 43EM** CC‐Welding Sculpture/Fabrication 814M** CC‐Yoga Teacher 351N** Other (Consult with an advisor before selecting) Prerequisite Courses AA Pre‐Nursing DTA/MRP AA RN Nursing WSUV DTA AA Associate in Arts DTA‐Undeclared PREQ** PREN AARN AAU Key for Degree Codes: AA – Associate in Arts AFA – Associate in Fine Arts AST – Associate in Science Transfer DTA – Direct Transfer Agreement MRP – Major Related Programs AAS – Associate in Applied Science AAT – Associate in Applied Technology CP – Certificate of Proficiency CA – Certificate of Achievement CC – Certificate of Completion ** – Ineligible for Financial Aid Revised 2/26/15