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Be Typed This Form MUST SOUTHEASTERN LOUISIANA UNIVERSITY (Southeastern Louisiana University)

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Rev. 3/12
This Form
MUST
ADVISOR / COMMITTEE REQUEST FORM
Be Typed
SOUTHEASTERN LOUISIANA UNIVERSITY
NAME:
Southeastern ID #:
W
(LAST) (FIRST) (MIDDLE)
ADDRESS:
(BOX-STREET) (CITY) (STATE) (ZIP)
DEGREE: _____________________________________________ MAJOR: _____________________________________________
Non-Thesis Master’s Signatures:
Typed Name Signature
Major Advisor: _____________________________________________ ____________________________________________
Graduate Coordinator: _______________________________________ ____________________________________________
NAME OF COMMITTEE MEMBERS:
Thesis Master’s or Doctorate Signatures:
Typed Name Signature
Major Professor:
Co-Major Professor:
Committee Member:
Committee Member:
Committee Member:
Committee Member:
Committee Member:
SIGNATURES:
Typed Name Program Graduate Coordinator Date
Typed Name Student Date
(Other necessary signature, e.g. Department Head/Dean)
Typed Name & Title Date
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Be Typed This Form MUST SOUTHEASTERN LOUISIANA UNIVERSITY (Southeastern Louisiana University)

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Completed 26 August 2020

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