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Declaration Form

 This form is to be used by students to declare their intention to complete the University Honors ProgramComplete and submit the form to your college honors coordinator.

 The form needs to be signed by your academic advisor and by the College Honors Coordinator. Then a copy should be sent to the Director of the University Honors Program, Dr. Donald Jones, in Auerbach 212i.


Please print neatly.

Name: __________________________________   ID#: ____________________________

Major:  __________________________________  Expected Graduation Date: ________                      

Local Address:  ___________________________________________________________

Phone: __________________________________  UofHemail: _____________________                                                      

Honors Courses (list both those completed and those anticipated):

Course                                             Credits           When Completed        Instructor











(18 credits plus the GPA required by your college honors program)

Required Signatures:

Student___________________________________________ Date _________________                                   

Advisor___________________________________________ Date _________________                                  

Print Advisor’s name_________________________________________________


Honors Coordinator _________________________________   Date _______________                                 

Dr. Donald Jones (for UHon)___________________________  Date _______________