White – Academic Department Copy Canary – Student Copy Revised 10/4/2016

UNIVERSITY OF MASSACHUSETTS AMHERST - COLLEGE OF ENGINEERING OFFICE USE ONLY COURSE SELECTION FORM

Last Name: First Name: MI: Student ID: Current Major:

Email Address: Cell Phone:

(If Different From Current Major)

Intended Major/Sub-Plan:

CURRENT Semester: Fill in Course Information Fall: Spring: NEXT Semester: Fill in Course Information Fall: Spring:

DEPT. &COURSE NO. COURSE TITLE CREDITS

GEN. ED. CODE

DEPT. &COURSE NO. COURSE TITLE CREDITS

GEN. ED. CODE

SOCIOL 321 EXAMPLE Sociology of Religion 4 SB DU HISTORY 110 EXAMPLE World History to 1500 4 HS DG

*Students Must Review Academic Requirements Report (ARR) to Confirm University Requirements are Satisfied* *Check All That Apply*

College Writing Junior Writing Biological Science Elective

Social World Elective RequirementsSee Academic Requirements Report

Athlete Veteran Honors

Marching Band Commuter Hrs./Wk. Currently Employed (On/Off-Campus) Hrs./Wk.

*What's Next? *Some Opportunities To Consider*

Scholarships REU/Research Internships/Coops

Study Abroad Domestic Exchange National Conferences

Civic & Community Engagement Engineering Management Minor Engineering Student Organizations

Student Government Fraternities/Sororities Registered Student Organizations

Experiential Learning: - Examples: Innovative Challenges, Independent Study,

Projects, Entrepreneurship, etc.)

Comments:

Student Signature: Faculty Signature: Date:

Use Black/Blue Pen Only

ESTIMATEDGRADE

A-/B+

Student ID: Email Address: Cell Phone: College Writing: OffJunior Writing: OffBiological Science Elective: OffAthlete: OffVeteran: OffHonors: OffMarching Band: OffCommuter: OffCurrently Employed OnOffCampus: OffHrsWk: HrsWk_2: Date: Intended Major, SubPlan: Current Major: Last Name: First Name: MI: YEAR Fall Next Sem: YEAR Spring Next Sem: YEAR Spring Current Sem: YEAR Fall Current Sem: DEPT COURSE_NUMBER 1: COURSE TITLE 1: Gen Ed Code 1: DEPT COURSE_NUMBER 2: COURSE TITLE 2: Credits 2: Gen Ed Code 2: DEPT COURSE_NUMBER 3: COURSE TITLE 3: Credits 3: Gen Ed Code 3: DEPT COURSE_NUMBER 4: COURSE TITLE 4: Credits 4: Gen Ed Code 4: DEPT COURSE_NUMBER 5: COURSE TITLE 5: Credits 5: Gen Ed Code 5: COURSE TITLE 6: Gen Ed Code 6: DEPT COURSE_NUMBER 7: DEPT COURSE_NUMBER 8: DEPT COURSE_NUMBER 9: DEPT COURSE_NUMBER 10: DEPT COURSE_NUMBER 11: DEPT COURSE_NUMBER 12: DEPT COURSE_NUMBER 6: COURSE TITLE 7: COURSE TITLE 8: COURSE TITLE 9: COURSE TITLE 10: COURSE TITLE 11: COURSE TITLE 12: Credits 7: Credits 8: Credits 9: Credits 10: Credits 11: Credits 12: Credits 6: Gen Ed Code 7: Gen Ed Code 8: Gen Ed Code 9: Gen Ed Code 10: Gen Ed Code 11: Gen Ed Code 12: AL,AT: [ ]SB: [ ]SWE4: [ ]HS: [ ]DU: [ ]DG: [ ]Comments: SWE Diversity: OffStudent Signature: Faculty Signature: Credits 1: Est: Grade 2: Grade 1: Grade 6: Grade 5: Grade 4: Grade 3: