External Committee Member Nomination 1
External Committee Member Nomination Form
Use this form to nominate an external committee member who a) is an expert in a given field, and b) is not
employed at UIW as a faculty member, and c) will serve only on a thesis or dissertation committee.
Membership is valid only once and only for the student specified.
Instructions: Committee Chair should complete front and back of form, attach nominee’s CV,
and send to Program Director, who sends to Office of Research & Graduate Studies for decision.
School or College:
Name of Student:
Name of Nominee:
Academic Training (chronological order, highest degree listed first):
College or University Dates Attended Degree and Date Awarded
Teaching, Professional, and Research Experience Relevant to the Topic (chronological order, most
on listed first):
Institution, Company, Other Empl
oyer, Rank/Position and Dates, Graduate Courses Taught
Relevant to the Topic (list by title and number):