Nebraska Indian Community College
DECLARATION OF MAJOR PLEASE PRINT CLEARLY
Campus: (Circle One)
Macy
Santee
South Sioux City
_______________________________________________________________/____-_____-____ Last Name
First
Middle
Maiden
Social Security #
________________________________________________________________________________________________ Street/PO Box City County State Zip Code
Note: Select only one (1). DEGREE AND MAJOR: ___ Associate of Arts – General Liberal Arts (AA-GLA) ___ Associate of Arts – Business Administration (AA-BUS)
___ Associate of Arts – Native American Studies (AA-NAS) ___Associate of Arts – Human Services (AA-HS) ___ Associate of Arts – Early Childhood Education (AA-ECE) ___Associate of Science – Science Studies (AS-SS) ___Associate of Applied Science – Carpentry (AAS-CPT)
___Enrichment ___Transfer credit to Another College ___ Dual Credit
CERTIFICATE: ___Carpentry (CERT-CPT) EXPECTED DATE OF COMPLETION: SEMESTER______
YEAR ______
Any change in this plan is to be discussed with an advisor or counselor and a new Declaration of Major form needs to be completed and forwarded to the Registrar’s Office. _____________________________________ Signature
_____________________________ Date
______________________________________ _____________________________ Advisor Date
OFFICE USE ONLY: Inputted into Empower by _____ on ___________
M a c y
•
S a n t e e
•
S o u t h
S i o u x
(NICC REVISED FALL 2013)
Empower ID # _________________
C i t y
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