Date Received (ocial Use Only):
DISSERTATION DEFENSE SCHEDULING FORM
To be completed by the Commiee Chair in consultaon 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 Dissertaon Defense Policy and Procedures for more informaon.
Dissertaon Title:
All commiee members must be present, in person, at the defense, unless prior approval is obtained from the Graduate College
using this form. If requesng approval for any commiee member to aend from a separate locaon, please provide the
scheduled SKYPE for Business, Lync Meeng informaon, or other web conferencing link:
Juscaon for request:
Please print commiee members’ names. If not all members will be on the Flagsta campus, please include the locaon where
members will be aending. Commiee signatures or emails verify that all commiee members have read the nal dra of the
dissertaon and agree that it is ready for defense.
Printed Name Signature OR Aached Email
Alternate Locaon
(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:
Locaon Building:
Room:
Is the presentaon poron of the defense open to the public?
If open to the public, please ensure that adequate seang and accessibility to a general audience is feasible.
Yes
No
If a separate public presentaon is required, please provide the following informaon:
Date:
Time:
Locaon Building:
Room:
Graduate College Approval:
Yes No
UGC Representave/Department:
Revised: 7/17/2019
