(1) Name:
 
(2) ID Number:
 
(3) Box Number:
 
(4) Phone Number:
 
(5) Are you a graduating senior? Yes No
 
(6) Do you have an I-20? Yes No
 
(7) DECLARATION OF MAJOR(S)/MINOR(S) All previous declarations of majors/minors and academic advisors will be deleted and information listed below will become your official record at Graceland.

      The pick lists below contain only majors/minors/concentrations for the current catalog.
      If you are pursuing an area no longer listed in the catalog, please enter it here:
          
Major 1:
Minor 1: 		Concentration 1:
Major 2:
Minor 2: 		Concentration 2:
Major 3:
Minor 3: 		Concentration 3:
Major 4:
Minor 4: 		Concentration 4:
Major 5:
Minor 5: 		Concentration 5:
 
(8) Teacher Education? Yes No
If yes, select your emphasis:
      Secondary 7-12, Combination K-12

      Endorsements Desired: (You may select more than one by holding down the Ctrl key)
          
 
(9) Are you following the current catalog for your major/minor? Yes No
If no, specify catalog.:
 
(10) Do you desire a change of adviser? Yes No
Current Adviser's Name:
Preferred Adviser's Name: