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 
□ Agritourism 
□ Applied Computer Science Technology 
□ Biomedical Laboratory Science 
□ Broadcast Communication 
□ Creative Educational Leadership for Change (post-graduate) 
□ Data Science 
□ Entrepreneurship 
□ 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