Revised: 11/17
Student’s Name: UWG ID#:
Dissertation Title:
Time Proposal Defense Occurred: Date: Time:
Location: UWG Campus Virtual
The Doctoral Dissertation Committee is responsible for ensuring that the dissertation contributes new
knowledge of fundamental importance or significantly modifies, amplifies, or interprets knowledge in a
new and important manner.
The Dissertation Chair is responsible for submitting the necessary paperwork for IRB approval after
completing this form and completing the Qualtrics Assessment of the proposal.
Assessment Link: https://goo.gl/T79VB8
By signing this form, all members affirm the study meets all ethical and responsible research
responsibilities; the proposal has been successfully defended; and all necessary assessments have
been completed.
Dissertation Chair: Member:
Member: Member:
Student’s Signature: Date:
Received: Date:
Ed.D. Director
Doctor of Education in Professional Counseling & Supervision
Dissertation Proposal Approval
(This form to be submitted by the chair prior to beginning data collection)
