OFFICE OF THE REGISTRAR ASSUMPTION COLLEGE

500 Salisbury Street Worcester, MA 01609-1296

CHANGE OF ADVISOR

STUDENT’S NAME:________________________________________________________________________

(PLEASE PRINT)

ID #: _____________________CLASS OF:___________CAMPUS BOX NO:__________

PLEASE BE INFORMED THAT MY NEW ADVISOR IS: ______________________________________

____________________________________________________________________________ _____________________________

NEW ADVISOR’S SIGNATURE DATE

PLEASE RETURN THE COMPLETED FORM TO THE REGISTRAR’S OFFICE