Division Change Form

Electronic receipt of your request with your LC email account listed will take the place of your signature.

Allow one business day to process the request.

All fields are required.

All fields marked with asterisk (*) are required.

required text field

ID Number*

required text field

Last Name*

required text field

First Name and Middle Initial*

required text field

Personal Phone*

required e-mail address field

LC Email Address*

required radio button field

Division Change*

Full-time to Part-Time Load

Part-time to Full-Time Load

required text field

Semester Effective*

Link (required)