Access and Enrollment 
REQUEST FOR CHANGE/ADDITION OF 
CERTIFICATE PROGRAM 
Name 
Student ID# 
Telephone: ( 
) 
Cell ( 
) 
E-mail
__ 
This form may only be used by students who have been formally admitted to a degree seeking status. Be aware that changes to degree level may 
impact financial aid eligibility – Certificate programs of study and courses are not eligible for Title IV Federal Financial Aid funding. 
Once completed email this form to registrar@uvi.edu 
Please indicate your choice by checking the appropriate boxes: 
Are you? 
□ Adding a Certificate Program 
Certificate Programs: (Please indicate your choice by checking the appropriate boxes) 
CERTIFICATE PROGRAMS 
□Agricultural Business
□Agrotourism
□Aquaculture
□Applied Computer Science Technology
□Biomedical Laboratory Science
□Broadcast Communication
□Creative Educational Leadership for Change (post-graduate)
□Data Science
□Entrepreneurship
□Forestry and Nursery Management
□General Agriculture
□Horticulture
□Inclusive Early Childhood Education
□Literacy Education (post-graduate)
□Music Industry
□Psychology
□Secondary Teaching
□Spanish
□Special Education (post-graduate)
□Teaching English as a Second Language
Student Signature 
Date 
Certificate Program Director 
Date 
New form 9/15/2021 
OFFICE USE ONLY: 
Processed by: 
Date entered:  
SIGN