Global Change Minor
Information Request Form
Thank you for your interest in the Global Change Curriculum and the Global Change Minor.

Please complete this form to inquire about the Global Change Minor. Your information will be sent to the program director, Prof. Ben van der Pluijm (vdpluijm@umich.edu), who will respond to you with a request for a time to meet. 

Please be sure to answer all questions when possible.  Use the "Comments" box for questions or when you are uncertain about Electives and are leaving fields blank.  This can be discussed at our meeting.

Note: You will not be able to submit this form if no e-mail address is entered.

Name (Last, First, Middle) 
Student ID #:
Your umich e-mail:
School or College:
Year of arrival at UM:
Core Courses
 
I have taken/plan to take GC1:Physical Processes (Environ110 and x-listed)) in W/F Year (e.g., F08): 
I have taken/plan to take GC2:Human Impacts (Environ111 and x-listed) in W/F Year (e.g., F08): 
I have taken/plan to take one of Environ256/270/281/284 in W/F Year (e.g., F08): 
Elective 1
 
I have taken/plan to take Elective 1 in W/F Year (e.g., F08):  

Category: 

Course number (3xx and up) and name: 

Credits: 

   The course is not on the current list, so I request approval 

Elective 2
 
I have taken/plan to take Elective 2 in W/F Year (e.g., F08):  

Category: 

Course number (3xx and up) and name: 

Credits: 

The course is not on the current list, so I request approval 

Elective 3 (replacing 200-level class)
 
I have taken/plan to take Elective 3 in W/F Year (e.g., F08):  

Category: 

Course number (3xx and up) and name: 

Credits: 

The course is not on the current list, so I request approval 

Comments

Please use the space below if you have any questions, comments or suggestions you would like to include:


 
  

last update: March 30, 2010