Degree Planner Course Change Request Form

Submitter's Full Name (Required):
First Name and Last Name (e.g. Jane Smith)

Email (Required):
Submitter's Full Email (e.g. jsmith@csusm.edu)

Department Chair Email (Required):
Full Email (e.g. mparker@csusm.edu)

I would like to (Required):
If you wish to add AND delete courses, they must be submitted on different forms.

Term (Required):

Subject (Required):
e.g. CS, DNCE, GEW

Catalog Number (Required):
e.g. 100, 310, 498A

Catalog Number:
e.g. 100, 310, 498A

Do you have more courses?

Are any of these courses Crosslisted or Combined with another course? (Required)

Yes, one course or more is crosslisted and both should be cancelled
Yes, one course or more is crosslisted and just the listed class(es) should be canceled
No, course(s) course is not crosslisted

Please check one of the following (Required):

I have received confirmation from my Department Chair's Office to modify the Degree Planner Report and will copy the confirmation below.
I have not received confirmation from my Department Chair and should not be filling out this form at this time.
The department chair is filling this form out her/himself.

Comments:
Please list anything else we should know here.