Revised August 2010
Selection of Examining Committee Members
Department of Biology
This form is to be used to document membership on examining committees for (1) non-thesis master's students
who are arranging for their final degree examination prior to graduation; and (2) doctoral students who are
preparing for the Graduate Written Exam.
After consultation with the faculty members named below, I request that they be appointed to serve on my
examining committee. I understand that this is subject to approval (indicated by signatures) by the
proposed committee members, and the Graduate Program Director.
Student
Printed name: ________________________ Signature: ______________________________ Date: _____________
Examining committee members:
1. Printed name: _____________________________ Signature: __________________________________
2. Printed name: _____________________________ Signature: __________________________________
3. Printed name: _____________________________ Signature: __________________________________
Graduate Program Director
Printed name: ________________________ Signature: ______________________________ Date: _____________