* Required Fields
SHUID #:*
Last name:* First name:*
Middle/Maiden Name:
SHU Email Address:*
Street Address:*
City:* State:* Zip:*
Division:* --Select-- Full-time Day Part-time Day Part-time Evening Year:* --Select-- 1L 2L 3L 4L
Which Semester do you want this to become effective?* --Select-- Spring Fall
Year to be effective:* --Select-- 2010 2011 2012 2013
Please describe your request completely; give reasons.*
Change of Division* From: To:
"I understand that if this application is approved, I must comply fully with all requirements including residency set forth by the School of Law." --Select-- Accept