Form 716 09 is an informational tax form used by taxpayers to report interest and dividends income. The form is relatively simple to complete, and instructions are provided on the reverse side of the form. taxpayers are responsible for reporting all interest and dividend income, even if it is not subject to withholding. Taxpayers should be sure to review the Form 716 09 instructions carefully prior to completing the form. By following the instructions, taxpayers can ensure that their information is reported accurately and that they receive any applicable credits or deductions.
| Question | Answer |
|---|---|
| Form Name | Form 716 09 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | Petition_to_Cha nge_Major_Curri culum_1509 petition to change major curriculum form |
California State Polytechnic University, Pomona Registrar’s Office
PETITION TO CHANGE MAJOR CURRICULUM
(For Undergraduate Students Only)
For office use only:
Received on: _________________
Processed on: _________________
By: _________________________
Name ________________________________________________________________ |
BroncoNumber _______________________ |
|||
(Last) |
(First) |
(M.I.) |
|
|
Address ______________________________________________________________ |
Home Phone ( |
) ___________________ |
||
(Number/Street |
|
|
|
|
______________________________________________________________ |
Work Phone ( |
) ____________________ |
||
(City) |
|
(State/Zip) |
|
|
Current Cal Poly Pomona GPA _______________ |
No. of Quarters at Cal Poly Pomona _______________ |
|||
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Fill out Section 1, 2 or 3 below, as appropriate:
1. FOR CHANGE OF MAJOR OR FOR DECLARING MAJOR FOR THE FIRST TIME:
Present Major (if not undeclared) ___________________________________ Option (if any) ______________________________
New Major Requested ___________________________________________ Option (if any) ______________________________
Reason for this change: ______________________________________________________________________________________
___________________________________________________ _____________________________________________________
Student Signature(Date) Signature/New Department Chair(Date)
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
2.FOR CHANGE TO DOUBLE MAJOR:
Present Major __________________________________________________ Option (if any) _____________________________
New Major Requested ___________________________________________ Option (if any) ______________________________
Reason for this change: ______________________________________________________________________________________
___________________________________________________ _____________________________________________________
Student Signature(Date) Signature/Second Department Chair (Date)
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
3.FOR CHANGE FROM DOUBLE MAJOR TO SINGLE MAJOR:
Present Major (1) _______________________________________________ Option (if any) ______________________________
(2) _______________________________________________
Major to be dropped ____________________________________________ Option (if any) ______________________________
Reason for this change: ______________________________________________________________________________________
___________________________________________________ _____________________________________________________
Student Signature(Date) Signature/Department Chair of Major to be dropped (Date)
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Curriculum Change
A student who has been in continuous enrollment* who is changing from one declared major to another is subject to the core and support requirements for the new major in effect at the time of the change of major. University General Education requirements do not change when such a student changes from one declared major to another.
A student who has been in continuous enrollment* who is changing from an undeclared major to a declared major is entitled to enter the new major under the entire curriculum in effect at the time the student entered this university.
An EOP student who transferred to Cal Poly from another college or university and has been in continuous enrollment* and who is changing from an undeclared major to a declared major is entitled to enter the new major under the entire curriculum in effect at the time the student entered a California community college or university.
Certification of General Education Requirements
Students who have received complete or partial certification of CSU General Education requirements from a prior institution and has remained in continuous enrollment* will retain that certification when changing majors.
- - - -
*A student is considered to be in continuous enrollment if, after first attending a California community college or California State University (including Cal Poly Pomona), he/she attends any two (2) of the four (4) quarters or one (1) semester during the calendar year (January 1 through December 31) at another college or university.
Please submit this form to the Registrar’s Office, Bldg. 98, 2nd Floor |