MIDLANDS STATE UNIVERSITY

ADMISSIONS, REGISTRATION AND STUDENT STATISTICS

Degree Programme Amendment Form

(To be completed in Triplicate and submitted to the Student Records and Registration)

Registered Student Data

Surname …………………………………. First Name(s) ………………………………

Registration No ………………………… Level ……………………………………….

Faculty………………………………………..Department……………………………….

Degree Programme:

Attendance Type……………………………………………………………………………

I hereby request that the following data on my official Student Records be amended as
indicated below:

Destination: Faculty/Department (Delete inapplicable)

Faculty………………………………… Department…………………………………

Degree Programme…………………………………………………………………………

Attendance Type………………………….. Level……………………………………….

Applicant’s Signature……………….. Date…………………………………………

RELEASING RECEIVING

Recommended/ Not Recommended Recommended/ Not Recommended

Departmental Chairperson: Departmental Chairperson:

Date: ………………………. Date: ………………………….

Recommended/ Not Recommended Recommended/ Not Recommended

Executive Dean of Faculty: Executive Dean of Faculty:

Date: ………………………… Date: …………………………...

Approved/ Not Approved

Deputy Registrar: …………………………….. Date ……………………..