Graduate Thesis & Committee Application
STUDENT INFORMATION:
Student ID: @
Phone Number:
Name: Last
First
M.I.
Local Address:
Street
City
State
Zip Code
THESIS INFORMATION:
Term: (Check One):
Fall 20
Wintersession 20_
Course:
Spring 20
Number of Credits:
Course Subject
Summer 20_
3
Session
6
Course Number
Title of Proposed Thesis*:
*Please attach a description of the proposed thesis to this application.
Student Signature:
Date:
PLEASE NOTE: A thesis prospectus should be completed and submitted to your adviser as soon as possible. The application needs
to be submitted to the School of Graduate Studies and Research at least one week prior to the beginning of the semester or session.
___________________________________________________________________________
Thesis Instructor: (Please Print)
SIGNATURES OF THESIS COMMITTEE MEMBERS:
Chair of the Thesis Committee (Printed name and signature)
Date
Member of the Thesis Committee (Printed name and signature)
Date
Member of the Thesis Committee (Printed name and signature)
Date
Member of the Thesis Committee (Printed name and signature)
Date
Member of the Thesis Committee (Printed name and signature)
Date
SIGNATURES OF APPROVAL:
created: 12/01/2003
Revised: 02/04/2013
Program Head
Date
Department Chairperson
Date
Graduate Dean
Date