Faculty of Health & Medical Sciences

School of Biosciences & Medicine

Module Change Request Form

Please note that caps on numbers mean some transfers will not be possible. The final date
for module change requests is the Friday of Week 2 of Semester.

Name:

Student URN:

Degree Programme:

Level:

Please state which module(s) you wish to switch FROM:

Please state which module(s) you wish to switch TO:

If the switch is not possible I would like to (please asterisk one option):

Revert to my original module

Switch to one of the following modules instead (please specify below)

Please state the reason for your requested change of module(s):

I have discussed the change(s) with my tutor (his/her name): _________________________

Signature of Personal Tutor: ______________________ Date: _____________________

Please submit this form electronically to ug_biochem_enq@surrey.ac.uk