This form is to be used by students to declare their intention to complete the University Honors Program. Complete 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 _______________
