Gerontology Minor Information Sheet

Please fill in the information requested below and return to the department secretary, June Anderson, in the psychology department office (Marcus White 211). This information sheet is for department records only. Please note that in order to officially declare a minor in gerontology, you must also complete the “Undergraduate Change of Major, Degree or Advisor” form, which must be signed by the psychology department chairperson and submitted to the Registrar’s office.

Today’s Date: ______________________________

Name: ____________________________________   Student ID: __________________

Address: _______________________________________________________________

Phone: ___________________________________________

E-mail: __________________________________________

Major: ___________________________________________

Expected year of graduation: __________________________

What are your reasons for choosing to minor in gerontology?