Please submit the completed form to the Educational Administration at the
Department of Engineering Sciences and Mathematics or send it via e-mail to
edutvm@ltu.se
The application refers to course code (see
programme/course syllabus)
DEGREE PROJECT - APPLICATION AND
DECISION
Student
Name
Personal identity number
Programme
Focus
Postal address
Postcode and city
Telephone/mobile
E-mail address (student account)
Degree Project
Working name/preliminary title
Planned start date
The report should be confidential
 NB An agreement between the department and company is
required
Required appendices
 A clear work description, including an implementation plan
 Transcript
 Any remaining courses, please specify on the back of this form.
In which degree will the planned thesis be included?
 Master of Science in Engineering 300 credits
 Master 120 credits
 Bachelor of Science in Engineering 180 credits
 Other:
Have you asked/requested a particular examiner? If yes, please state the name and division of the examiner
Supervisor at the company/LTU division
Name
Title
Company/LTU division
Postal address
Postcode and city
E-mail
I hereby certify that the above information is correct
Date
Signature + name of the student
Admission requirement assessment (to be filled out by the department)
Credit requirements in accordance with the current course syllabus have been verified
Date
Verified by
 Have been met
 Have not been met
Decision (to be filled out by the department)
 Approved (the subject matter is of satisfactory scope and admission requirements have been met)
 Rejected, se following page
Date
Examiner/Director of Undergraduate Studies, signature + name
1(2)
Please submit the completed form to the Educational Administration at the
Department of Engineering Sciences and Mathematics or send it via e-mail to
edutvm@ltu.se
Registration (to be filled out by the department)
Examination 0001 Start of thesis semester/date
Examination 0002 Public discussion of another thesis, date
Examination 0003 Oral presentation
Examination 0004 Approved written report
Remaining courses
In order to start on your thesis, the specific admission requirements must be fulfilled, see current course syllabus. If you have any
outstanding courses, which are to be included in your degree, please specify the courses and when you intend to complete them (state the
course elements that are incomplete). Courses completed at other universities, which are not included in your transcript, must also be
provided.
Course code
Course name
Date when the course is
to be completed
 Remaining courses correspond to the information in Ladok (to be verified by the Educational Administration)
Reasons for rejection
2(2)