Pitzer College Office of the Registrar SPECIAL MAJOR DECLARATION FORM For students entering Fall 2016 and after Name ID# Expected Grad Date _ Contact Phone Number _ Contact E-mail _ Special Major Field(s) _Special Major Title ATTACH SPECIAL MAJOR PROPOSAL TO THIS FORM PLEASE LIST COURSE NUMBER AND TITLE CHECK BOX NEXT TO COURSES ALREADY COMPLETED A) INTERCULTURAL UNDERSTANDING D) WRITTEN EXPRESSION – Check One Line Local – Program or Course Number and Title: First-Year Seminar – Course Number and Title: _ _ _ _ Global – Program or Course Number and Title: Writing Intensive Course - Course Number and Title: _ _ _ _ B) SOCIAL RESPONSIBILITY / JUSTICE Justice Theory – Course Number and Title: _ _ Responsibility Praxis – Course Number and Title: _ _ C) BREADTH OF KNOWLEDGE (Students may not count the same course toward meeting more than one breadth of knowledge area.) a) Humanities/Fine Arts 1) _ 2) _ E) MAJOR COURSES – List Course Number & Title Course # Course Title 1) _ 2) _ 3) _ 4) _ 5) _ 6) _ 7) _ 8) _ b) Social/Behavioral Science 9) _ 1) _ 10) _ 2) _ 11) _ c) Natural Science 12) _ _ CAPSTONE _ d) Quantitative Reasoning _ **ADVISORS: By signing this form you confirm you are part of the appropriate field group and that you will act as the student’s major advisor **STUDENTS: Special majors require at least two advisors, one of which must be a Pitzer Advisor _ _ Major Advisor Print Name College Date Signature _ Major Advisor Print Name College Date Signature _ Student’s Signature Print Name College Date Additional Advisor’s Print Name College Date Signature S:\forms\Major Form 2016.doc