Health and Wellbeing Minor Interest Form

First Name

Last Name

UVA Email Address

UVA Student Number

Birthdate

When do you expect to graduate?

What is your current cumulative GPA as shown in SIS?

What is the total number of credits you have completed, including transfer credits, as shown in SIS?

What UVA school are you enrolled in?

What is your current major? (put "undeclared" if appropriate)

Why are you interested in the Health and Wellbeing Minor?

By selecting Yes below, I pledge as a UVA student that my responses above are accurate and correct.

Yes

No

By submitting this form, you are expressing an interest in the Health and Wellbeing Minor.

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