SUU Graduate Studies
Approval Form for Capstone Experience
This form serves as the official record of the graduate capstone experience submission to the Registrar’s Office and must be
submitted before the graduate degree may be awarded. Please print all information clearly.
Student’s Full Name: ___________________________________________________________________
T Number:___________________________________ Graduation Date (mo/yr):_________________
Degree Type (please circle): MA MS MEd MBA MAcc MFA MPA
Name of Department or College:__________________________________________________________
Graduate Program:_____________________________________________________________________
Capstone Title (optional):________________________________________________________________
_____________________________________________________________________________________
Student Agreement:
1. I hereby certify that, if appropriate, I have obtained permission statements of each third-party copyright holder.
2. I certify that, if appropriate, I have submitted the same final copy of relevant documents approved by my committee.
3. If selected below, I hereby grant SUU the non-exclusive license to archive and make accessible my portfolio, project, or other
relevant documents in all forms of media. I retain all other ownership rights to the relevant materials. I also retain the right to
use in future works (such as books or articles) all or part of my capstone or other relevant documents.
Student and Committee Agreement (select one of the following)
___ 1. Release the entire work immediately for access worldwide.
___ 2. Secure the entire work for proprietary purposes.
Review and Acceptance: The aforementioned documents have been reviewed and approved by the student’s
supervisory committee. The undersigned agree to abide by the statements above, and confirm that this Approval
Form serves as the Certificate of Approval for the capstone experience, including any abstracts enclosed within.
This form will fulfill all incomplete requirements for capstone course work and incomplete grades will be updated
on the student’s academic record.
Student:
__________________________________ ________________________________ _________
Printed Name Signature Date
Chair Name:
__________________________________ ________________________________ _________
Printed Name Signature Date
Graduate Program Director:
__________________________________ ________________________________ _________
Printed Name Signature Date
Graduate Dean:
__________________________________ ________________________________ _________
Printed Name Signature Date
Grade: __________________
(To be assigned by the Committee Chair) Form revised 04/12/10
