Change of Mentor Request Form

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Change of Mentor Request Form

OFFICE OF THE REGISTRAR

Use this form to request a change of Mentor

Student Information

Name*

First Name*

Last Name*

CalArts Email Address*

Student ID*

School*

Degree Level*

Year-Level*

Mentor Information

Change my Mentor on record from:*

Change my Mentor on record to:*

Confirm Mentor Email Address associated with this change*

Note, this will determine which Mentor this form is routed to for approval.

Acknowledgment

By signing here I am authorizing the Office of the Registrar to make these changes to my academic record.

Today's Date*

https://calarts.formstack.com/forms/images/2/calendar.png

Month

Day

Year

Student Signature*

[clear]

Use your mouse or finger to draw your signature above

Mentor Approval

Is this request approved by the new Mentor?*

Yes No

School associated with this change?*

School of Art School of Critical Studies School of Dance School of Film/Video School of Music School of Theater

Note, this will determine which Dean this form is routed to for approval.

Notes/Comments

Today's Date*

https://calarts.formstack.com/forms/images/2/calendar.png

Month

Day

Year

Mentor Name*

First Name*

Last Name*

Mentor Signature *

[clear]

Use your mouse or finger to draw your signature above

Dean Approval

Is this Mentor change approved by the Dean?*

Yes No

Notes/Comments

Today's Date*

https://calarts.formstack.com/forms/images/2/calendar.png

Month

Day

Year

Dean Name (or authorized Designee)*

First Name*

Last Name*

Dean Signature (or authorized Designee)*

[clear]

Use your mouse or finger to draw your signature above

Registrar Processing

Student record updated on:*

https://calarts.formstack.com/forms/images/2/calendar.png

Month

Day

Year

Student record updated by:*

First Name*

Last Name*

Notes/Comments

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