Date Received (ocial Use Only):
DISSERTATION DEFENSE SCHEDULING FORM
To be completed by the Commiee Chair in consultaon with the student
NAME:
NAU ID:
NAU EMAIL:
DEGREE/PROGRAM:
ADVISOR/MAJOR PROFESSOR:
This form must be completed, signed (electronic signatures are accepted), and sent to the Graduate College ETD Coordinator a
minimum of 10 business days before the dissertaon defense. Please note: this process is separate from the format check.
Please refer to the Dissertaon Defense Policy and Procedures for more informaon.
Dissertaon Title:
All commiee members must be present, in person, at the defense, unless prior approval is obtained from the Graduate College
using this form. If requesng approval for any commiee member to aend from a separate locaon, please provide the
scheduled SKYPE for Business, Lync Meeng informaon, or other web conferencing link:
Juscaon for request:
Please print commiee membersnames. If not all members will be on the Flagsta campus, please include the locaon where
members will be aending. Commiee signatures or emails verify that all commiee members have read the nal dra of the
dissertaon and agree that it is ready for defense.
Printed Name Signature OR Aached Email
Alternate Locaon
(approval required)
Co-Chair
Chair
Member
Co-Chair
Chair
Member
Co-Chair
Chair
Member
Co-Chair
Chair
Member
Co-Chair
Chair
Member
The Oral Defense is scheduled for:
Date: Time:
Locaon Building:
Room:
Is the presentaon poron of the defense open to the public?
If open to the public, please ensure that adequate seang and accessibility to a general audience is feasible.
Yes
No
If a separate public presentaon is required, please provide the following informaon:
Date:
Time:
Locaon Building:
Room:
Graduate College Approval:
Yes No
UGC Representave/Department:
Revised: 7/17/2019