OFFICE OF THE REGISTRAR Waterloo, Ontario, Canada N2L 3G1 519-888-4567, ext. 35378 | fax 519-746-2882 | www.registrar.uwaterloo.
ca
Plan Modification/Application for Internal Transfer Form
Instructions 1. Print in block capital letters unless a square ( ) is required. 2. Sign and date the form below. 3. Attach a rsum of your work experience if you are applying for a Co-op Plan and were not previously registered in Co-op. 4. Make a copy for your records, and submit the original Plan Modification/Application for Internal Transfer Form and rsum (if applicable) to the Office of the Registrar. Note: Normal processing time is 2 weeks, but may be subject to a review of your most recent academic performance.
Please select one as appropriate: Plan Modification Application for Internal Transfer, e.g., Faculty transfers (complete pages 1 and 2)
uWaterloo Student ID Number
Surname Email Home Phone
Street
Given Name(s) Mailing Address
Business Phone
City Province Postal Code
Requested Academic Information Include all majors, minors, options, and specializations under Current and Requested Academic Plans. Current Academic Plan Honours 4-Year General 3-Year General Academic Program Non-degree/Post-degree Exchange Form of Study Campus Requested Academic Plan Academic Program Form of Study Campus Start Term Regular Co-op UW STJ Online REN UAE
Honours 4-Year General 3-Year General Non-degree/Post-degree Exchange Regular Co-op Online UW Fall STJ REN UAE Year ______ Winter Spring
Reason for Request Indicate your academic interests in the Requested Plan and explain the reasons for changing your Plan. Attach additional pages as necessary.
Student Signature
Date
Plan Modification Approvals See overleaf for Internal Transfer Approvals Admit Refuse
Reset
Only where changes are required, indicate the Undergraduate Calendar regulations to be followed for the requested plan modification above.
Academic Program Type Calendar Year (e.g., 2010-2011) ________________ Options/Minors Calendar Year (e.g., 2010-2011) ______________ Comments
Academic Plan Calendar Year (e.g., 2010-2011) ________________
Department Approval Name
Signature
Extension Number
Date
Co-operative Education and Career Services Approval Name (if applicable)
Page 1
Signature
Extension Number
Date
REGISTRAR APR. 2011 5171-1
Please print clearly.
Internal Transfer Form
Admitted to __________________________________________________________________________________________________________________ Academic Level (e.g., 2B) ___________
Only where changes are required, indicate the Undergraduate Calendar regulations to be followed for the requested internal transfer.
Academic Program Calendar Year (e.g., 2010-2011)_____________________ Options/Minors Calendar Year (e.g., 2010-2011) _______________________ Refused Defer
Academic Plan Calendar Year (e.g., 2010-2011) ______________________
Refer to__________________________________________________________________________________________
Courses required by admitting department.
Primary Meet Class No. (4 char.) Subject Catalog Number Primary Meet Section No. (3 char.)
Select if Quest enrolment access denied for student (courses to be entered by the Registrars Office)
Class Number for Related 1 (4 char.) Related 1 Section Number (3 char.) Class Number for Related 2 (4 char.) Related 2 Section Number (3 char.) Enrolment Session (Regular/ Online) Grading Basis (e.g., AUD, NGP, XTR) Requirement Designation (e.g., XTRA)
Admitting Officer Approvals (include names, signatures, dates, and extension numbers for Joint Programs)
Name Signature Date Extension Number
Name
Signature
Date
Extension Number
Co-operative Education and Career Services Approval (if applicable)
Name
Page 2
Signature
Date
Extension Number