Please return completed form to the Graduate Administrator, Room 3432ME.
Civil and Environmental Engineering
Request for a Change of Program (i.e. M.Eng. to M.A.Sc.)
Date of Request: Student Name: Department Student Number: Mailing Address: Email Address: Home Phone:
___________________________ ___________________________ Civil and Environmental Engineering ___________________________ ________________________________________________________ ___________________________ ______________________ Work Phone: _______________________
Type of Program change _______________________________________________________ Reason for Program Change: (extra pages may be added) __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ Student - Signature Thesis Supervisor - Comments __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ Thesis Supervisor - Signature Associate Chair, Graduate Studies - Comments __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ Associate Chair, Graduate Studies - Signature For Office Use Only