Change of Status Form
Simon Graduate School of Business, University of Rochester
Registrar’s Office, 305 Schlegel Hall
Directions:
•
•
Complete this form if a student is changing from full-time to part-time or from part-time to full-time.
Return the completed form to the Registrar’s Office for processing.
Student Name: _____________________________________________________
Please print
Last
First
Today’s Date: ______________
MI
Student signature: ______________________________________________
Mo.
Day Year
UID#: _____________________
Change of Status
___________From full-time to part-time
___________ From Part-time to Full-time
Effective Date: ________________________
Effective Quarter for New Program: ______________
Mo.
Day
Year
Check your current program
_____ MBA (Master of Business Administration)
_____ MSB (Master of Science in Business Admin)
_____ MSF (Master of Science in Finance)
_____ MSA (Master of Science in Accountancy)
_____ MSM (Master of Science in Management)
_____ Part-time Flexible MBA
_____ Accelerated Professional MBA (PMBA)
_____ Ph.D
Change to Scholarship
______yes
______ no
Expected Graduation Term:
Fall ______Winter ______Spring _____ Summer ______
Not applicable if completing MS and starting MBA as student will show up on
NEW student list sent by Admissions with new scholarship amount.
Distribution of Scholarship (if applicable) for remainder of academic year: _________fall __________winter
____________spring ______________summer
APPROVAL SIGNATURE
__________________________________________
Admissions Department
___________________
Date
Registrar’s Office Only
Copies of form sent to:
___Bursar
____Student file
Date received: ______________
___Financial Aid
____ International Services Office ISO
Date processed: _____________
___Career Center CMC
____ University Health Service
Processed by: _______________
___Simon IT Dept.
Rev 8/2013