Office of Admissions & Records
25555 Hesperian Boulevard , Bldg. 700
Hayward, California 94545
Tel : (510) 723-6700
Fax : (510) 723-7510
STUDENT DATA CHANGE FORM
STUDENT ID #: ____________________________________________________
FULL NAME : _______________________________________________________
Last
First
Middle
Please also notify this department:
 Financial Aid
 International Student Program
 Veterans Services Office
PLEASE PRINT
ADDRESS CHANGE
PREVIOUS ADDRESS:
 Residence  Mailing
CURRENT ADDRESS:
 Residence  Mailing
__________________________________________________________________
Number and Street
Apartment #
__________________________________________________________________
Number and Street
Apartment #
__________________________________________________________________
City
State
Zip Code
__________________________________________________________________
City
State
Zip Code
Email:
PHONE NUMBER CHANGE
Home: (
)
Work: (
)
Mobile (
)
NAME CHANGE
FROM (PREVIOUS)
TO (CURRENT)
__________________________________________________________________
Last Name
__________________________________________________________________
Last Name
__________________________________________________________________
First Name
Middle
__________________________________________________________________
First Name
Middle
OTHER CHANGES
 Campus change to Chabot College
 Correct Birthdate to: _________/___________/__________
Effective Term:_______________________________________
If you are changing your campus to Chabot, you must also choose
a Chabot major.
(Proof required. E.g., Government issued ID, birth certificate, etc.)
Verified by A&R Staff:_________________________________
 Change Major Code to:_____________________________
 Correct SSN to: __________/_____________/___________
(See Major Code Sheet.)
(Proof of SSN card required.)
Effective Term:_______________________________________
Verified by A&R Staff:_________________________________
 Please do not disclose my address and phone number to any 3rd party not affiliated with the College.
Date:
Student’s Signature

OFFICE USE ONLY
Posted by: ________________________________
Date Forward to Financial Aid________________
Date posted by A&R _______________________
Date Forward to ISP ________________________
NOTES:
Date Forward to Veterans Services ___________
Received
Date:
Revised PL:rb 03/27/2015
CHABOT COLLEGE
25555 Hesperian Blvd
Hayward, CA 94545
MAJOR / CERTIFICATE TITLES
AA-T DEGREE
2238
2239
1512
1513
0027
0028
1518
1519
2231
2232
Anthropology (CSU GE)
Anthropology (IGETC CSU)
Communication Studies (CSU GE)
Communication Studies (IGETC CSU)
Elementary Teacher Education (CSU GE)
Elementary Teacher Education (IGETC CSU)
English (CSU GE)
English (IGETC CSU)
Geography (CSU GE)
Geography (IGETC CSU)
2229
2234
1108
1109
1037
1041
1036
1040
Sociology (CSU GE)
Sociology (IGETC CSU)
Spanish (CSU GE)
Spanish (IGETC CSU)
Studio Arts (CSU GE)
Studio Arts (IGETC CSU)
Theatre Arts (CSU GE)
Theatre Arts (IGETC CSU)
0608
0609
0828
0829
1038
1039
2228
2233
2003
2004
Journalism (CSU GE)
Journalism (IGETC CSU)
Kinesiology (CSU GE)
Kinesiology (IGETC CSU)
Music (CSU GE)
Music (IGETC CSU)
Political Science (CSU GE)
Political Science (IGETC CSU)
Psychology (CSU GE)
Psychology (IGETC CSU)
2199
2133
1704
1705
Early Childhood Education (CSU GE)
Early Childhood Education (IGETC CSU)
Mathematics (CSU GE)
Mathematics (IGETC CSU)
1102
2205
1027
2215
4902
4903
0601
4919
4920
4923
4924
4932
4918
4921
4922
4925
4933
4943
4941
4939
4937
French
Geography
4935
4942
Graphic Design
Human Services
4940
Humanities (General)
4938
International Studies
4936
4934
Journalism
Liberal Arts-Opt I Arts/Humanities
0603
Liberal Arts-Opt I Comm. English Lang.
1701
Liberal Arts-Opt I Social/Behavioral Sci.
1204
Liberal Arts-Opt I Math/Science
1011
Liberal Arts-Opt I Kinesiology/Wellness
1206
Liberal Arts-Opt II Arts/Humanities (CSU GE)
1013
Liberal Arts-Opt II Comm. English Lang. (CSU GE)
0804
Liberal Arts-Opt II Social/Behavioral Sci. (CSU GE)
0605
Liberal Arts-Opt II Math/Science (CSU GE)
0519
Liberal Arts-Opt II Kinesiology/Wellness (CSU GE)
2204
Liberal Arts-Opt III Arts/Humanities (IGETC CSU)
1105
Liberal Arts-Opt III Comm. English Lang. (IGETC CSU)1505
Liberal Arts-Opt III Social/Behavioral Sci. (IGETC CSU 1008
Liberal Arts-Opt III Math/Science (IGETC CSU)
Liberal Arts-Opt III Kinesiology/Wellness (IGETC CS
Liberal Arts-Opt III Art/Humanities (IGETC UC)
Liberal Arts-Opt III Comm. English Lang. (IGETC UC
Liberal Arts-Opt III Social/Behavioral Sci. (IGETC UC
Liberal Arts-Opt III Math/Science (IGETC UC)
Liberal Arts-Opt III Kinesiology/Wellness (IGETC UC
Mass Communications
Mathematics
Medical Assisting
Music
Nursing
Photography
Physical Education
Radio and Television Broadcasting
Real Estate
Social Science (General)
Spanish
Speech Communication
Theater Arts
0548
0549
1902
0759
0758
0994
0922
0576
2129
2128
Business (Emph. in Marketing)
Business (General)
Chemistry
Computer Science (Emph. in Math)
Computer Science (General)
Electronics Systems Technology
Engineering
Entrepreneurship
Fire Prevention Inspector
Fire Technology
2221
0935
0204
0939
1702
0941
0545
0750
0953
Human Services
Industrial Technology
Interior Design
Machine Tool Technology
Mathematics
Numerical Control
Retail Management
Software Specialist
Welding Technology
CSU General Education Breadth
Early Childhood Devel. (Basic Teacher)
Early Childhood Intervention Assistant
Fire Prevention Inspector
Fire Technology
Fitness Instructor
Health Care Management
Human Resources Assistant
IGETC (CSU GE)
IGETC (UC)
Industrial Electronic Technology
Interior Design
Kitchen and Bath Design
0940
0544
0538
1205
0942
0531
0520
0556
0552
0757
0812
0949
Machinist
Management
Marketing
Medical Assisting
Numerical Control Programmer (Machinist)
Office Technology
Real Estate
Retail Management
Small Business Management
Software Specialist
Sports Injury Care
Tool Maker
Fitness Instructor
Forensics
Geographic Information Systems
Graphic Design
ICT Cloud Infrastructure
ICT Cloud Services
Inspection and Pipe Welding
Interpersonal Communication
Multicultural Aware./Relations-Ser. Provider
Multicultural Aware./Self-Reflection
Music Industry Entrepreneur
0557
0830
1014
0574
0573
0569
0529
1522
0824
0030
0952
Office Technology
Personal Fitness Training Entrepreneurship
Photography
Project Management
Real Estate
Real Estate Entrepreneur
Retailing
Rhetoric
Sports Injury Care
Technical Design
Welding
Illustration
Writing
4946
0099
0093
0000
AS-T DEGREE
0014
0015
0572
0575
Administration of Justice (CSU GE)
Administration of Justice (IGETC CSU)
Business Administration (CSU GE)
Business Administration (IGETC CSU)
AA DEGREE
2101
2230
0201
1002
1004
1005
1006
1043
2209
0402
0403
0703
0705
1202
2105
2130
1508
0304
2203
2121
2120
Administration of Justice
Anthropology
Architecture
Art (Emph. in Ceramics)
Art (Emph. in Painting)
Art (Emph. in Sculpture)
Art (General)
Art History
Behavioral Science (General)
Biology
Biology (Emph. in Allied Health)
Computer Science (Emph. in Math)
Computer Science (General)
Dental Hygiene
Early Childhood Development
Early Childhood Intervention
English (Emph. in Literature)
Environmental Studies
Ethnic Studies
Fire Prevention Inspector
Fire Technology
AS DEGREE
0501
0526
0210
0991
0987
0988
0989
0990
0986
0547
Accounting
Administrative Assistant
Architecture
Auto Technology (BMW Manufacture Training)
Auto Technology (Emph. in Chassis)
Auto Technology (Emph. in Drivetrain)
Auto Technology (Emph. in Engine Machining)
Auto Technology (Emph. in Engine Performance)
Auto Technology (Emph. in Maintenance)
Business (Emph. in Management)
CERTIFICATE OF ACHIEVEMENT
0525
0527
0809
0213
0974
0975
0976
0977
0978
0564
0562
0810
0993
Accounting Technician
4927
Administrative Assistant
2118
2131
Aquatics
2127
Architecture Technology
2126
Automotive Chassis Technology
0811
Automotive Drivetrain Technology
Automotive Engine Machining (Financial Aid Ineligib 0563
0565
Automotive Engine Performance Technology
4944
Automotive Maintenance Technology
4928
Bookkeeping
Business-Transfer
0995
0208
Coaching
0211
Consumer Technology
CERTIFICATE OF PROFICIENCY
0568
0821
0992
0751
0567
2218
0822
0016
1025
2117
0570
Administrative Assistant Entrepreneur
Aquatics
Automotive Technology Entrepreneur
Business Graphics
Business Skills
Case Management for Human Services
Coaching
Consumer Technology Entrepreneur
Digital Design
Early Childhood Devel. (Associate Teacher)
Entrepreneurship
CERTIFICATE
1506
1024
Creative Writing
Digital Media
(NOT TRANSCRIPTED & FINANCIAL AID INELIGIBLE)
0823
1520
2220
1015
0766
0767
0979
1521
2212
2211
1034
OTHER
(NOT TRANSCRIPTED & FINANCIAL AID INELIGIBLE)
1019
1507
(NOT TRANSCRIPTED)
Liberal Arts and Sciences / Transfer
Other/Not Listed (Financial Aid Ineligible)
Personal Development (Financial Aid Ineligible)
Underclared (Financial Aid Ineligible)