GEORGIA INSTITUTE OF TECHNOLOGY
GEORGE W. WOODRUFF SCHOOL OF MECHANICAL ENGINEERING
WOODRUFF SCHOOL GRADUATE STUDENT CHECKOUT CLEARANCE
Failure to complete and submit this form might result in a delay in your graduation.
Please submit this signed form to the Associate Chair for Graduate Studies along with
the Certificate of Thesis Approval.
Student Name:
_______________________________________
Advisor:
_______________________________________
Building/Office:
_______________________________________
E-Mail:
_______________________________________
The student has returned all equipment and/or has cleaned experimental areas in the Undergraduate
Laboratories.
_____________________________________________
Sterling Skinner, Room 3327 MRDC
______________________
Date
The student has returned all equipment to the Electronics Laboratory.
_____________________________________________
Vladimir Bortkevich, Room 2317 MRDC
_____________________
Date
The student has returned all equipment to the Machine Shop.
_____________________________________________
John Graham, Room 2323 MRDC
___________________
Date
The student has returned all keys to the Facilities Office.
_____________________________________________
Dorothy McDuffie-Alexander, Room 2206 MRDC
___________________
Date
The student has signed their Annual Statement of Reasonableness (ASR).
_____________________________________________
Nancy Hutton, Room 3207 MRDC
___________________
Date
The student has returned all equipment and/or has cleaned experimental areas.
_____________________________________________
Faculty Advisor
__________________
Date
08/12