Doctor of Philosophy in
Mathematics and Science
Education
Application to Take the Preliminary Examination
MTSU ID #
Last Name:
First Name:
Mailing Address:
City:
State:
Phone:
E-mail:
Concentration Area (mark one)
☐ Biology
☐ Chemistry
Education
Education
☐ Mathematics
Education
Zip:
☐ Interdisciplinary
Education
When do you plan to take the preliminary examinations?
☐ Fall
☐Spring
☐ Summer
Year:
Student Signature
Date
Advisor Signature
Date
Important Notes:
 This form is due to the program director by the tenth (10th) class day of the semester in
which the exam is to be taken.
 An unofficial transcript should be submitted along with this form along with a copy of
your degree plan.
 You must be registered in at least one course during the semester in which you take the
preliminary examination.
This section is to be completed by the program director.
____ Residency Requirement Met
____ Degree Plan Filed and Revisions
Approved
____ GPA Entering Preliminary
Examination