Revised September 1, 2018
Approval of Thesis or Dissertation Committee
Thesis
Dissertation
Name:
Student
ID #:
Last
First
M.I.
Academic
Department:
Academic
Program:
Title/Topic
of Research:
Authorizations
Committee Chair:
Printed Name
Signature
Date
Committee Member:
Printed Name
Signature
Date
Committee Member:
Printed Name
Signature
Date
Committee Member:
Printed Name
Signature
Date
Committee Member:
Printed Name
Signature
Date
Department Chair:
Printed Name
Signature
Date
Home College Dean:
Printed Name
Signature
Date
CGPS Dean:
Printed Name
Signature
Date
Committee must include a minimum of three members of the graduate faculty, no more than one of whom may be a
non-tenure track faculty member. Doctoral committees must include one member from outside the student’s major
area.
Scan this form and email to the College of Graduate and Professional Studies, ISU-GradInfo@indstate.edu
. Forms will
only be accepted when emailed from the department or college.
Copy to be retained in ImageNow.