ARKANSAS TECH UNIVERSITY
DISSERTATION DEFENSE FINAL REPORT
This form should be completed and filed with the Graduate College after the dissertation final
defense is completed.
STUDENT NAME: _______________________________________________ T NUMBER: _____________________________
EMAIL ADDRESS: ________________________________________________________ PHONE: ________________________
DISSERTATION TITLE:
DATE OF FINAL DEFENSE: _________________________________________________________________________________
DISSERTATION FINAL DEFENSE: ☐ PASSED ☐ FAILED
SIGNATURES OF DISSERTATION COMMITTEE MEMBERS:
________________________________ ________________________________ _______________ ☐ PASSED ☐ FAILED
CHAIR NAME (PRINT) SIGNATURE DATE
________________________________ ________________________________ _______________ ☐ PASSED ☐ FAILED
COMMITTEE MEMBER (PRINT) SIGNATURE DATE
________________________________ ________________________________ _______________ ☐ PASSED ☐ FAILED
COMMITTEE MEMBER (PRINT) SIGNATURE DATE
________________________________ ________________________________ _______________ ☐ PASSED ☐ FAILED
COMMITTEE MEMBER (PRINT) SIGNATURE DATE
________________________________ ________________________________ _______________ ☐ PASSED ☐ FAILED
COMMITTEE MEMBER (PRINT) SIGNATURE DATE
SIGNATURES OF APPROVAL:
_____________________________________________________________________________________ ___________________________
Program Director Date
_____________________________________________________________________________________ ___________________________
Dean of the Graduate College Date
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit