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Application for Change/Add/Discontinue a Program for Currently Enrolled Graduate Students

DIRECTIONS: The Change/Add/Discontinue a program is a paper process, including letters of recommendations. Do not fill out an online admission application. On-line admission applications submitted by currently enrolled graduate students will not be processed.
1) Check with your intended program concerning their admission requirements.(For example: test scores, letters of recommendations and current transcripts from UW-Madison and previously attended institutions. Note: the graduate school will not make copies of transcripts). You can request a current UW-Madison transcript through: http://ordertranscript.wisc.edu.
2) Complete and print this form. Send it, along with required supporting documents, to your intended program.
NOTE: Your intended program will review your request to change or add a program and forward their admission decision to the Graduate School.

Name:
 
(Last)
(First & Middle)
Student ID Number
Address:
 
E-mail:
Telephone Number

Current program(s) --select from pull-down list:
Request change of program to-- (Select from pull-down list):
Request addition of program-- (Select from pull-down list):
  
  
program to be discontinued--select from pull-down list:*:
*Complete only if you currently have a joint or double program and wish to discontinue one. The Graduate School will notify both departments.
Effective for: Fall Spring Summer
Date of Master's examination already taken or planned to take in current program (month & year):    
Have you taken the preliminary Ph.D. examination in your current program? Yes No If yes, when?  
Reasons for change of program/addition of program (attach a separate sheet if neccessary):
____________________________________
____________________________________
Signature of Student
Date
The Graduate School | UW Home
Last update: 20 May, 2013
Feedback, questions or accessibility issues: gswebmaster@grad.wisc.edu
Copyright © 2010 The Board of Regents of the University of Wisconsin System.
PROGRAM USE ONLY
Please indicate departmental recommendation below and return original to Graduate School.
Program is responsible for notifying student of refusal or program withdrawal.
_____ Admit
_____ Admit on Probation
_____ Admit with Deficiencies
_____ Admit on Probation with Def.
_____ Refuse Admission
 If recommended on probation and/or with deficiencies, state conditions for first semester:


Signed:
________________________
 __________
Chair/Director of Admissions
 Date
PROGRAMS MUST COMPLETE THIS AREA FOR ALL INTERNATIONAL ADMITTED APPLICANTS
Degree Goal is: Master's Ph.D. Estimated Completion Date: ______________
 
Month & Year
Date recieved by Program: ________________________________________ Date Sent to Grad School:______________________________________________________
May 20, 2013
For help contact: gswebmaster@grad.wisc.edu