Physical Therapist Assistant Change of Major Form

Instructions

Complete this form, print it, sign it, and return it to the Records Office in Conklin to be considered for the Physical Therapist Assistant program.

***Deadline: November 30 to be considered for the next fall semester.***
Note: You will receive a letter about your status by March.

Questions?

Contact Renee Borromeo at 717-749-6020 or [email protected].

Name

PSU ID Number

Current Major or College

I request permission to change my major to 2PTA (Physical Therapist Assistant) from my current Major or College.

Effective Fall Semester, Year:

Student Signature

Instructions

You're almost done! Now that you've filled in the fields above, please print this page and sign it. You'll take your signed copy to the Records Office in Conklin Hall to be considered for the Physical Therapist Assistant program.

When you have printed your copy, you may click the button below to send this form to your email address.

Telephone