Fillable Final Phd Exam Request Doctoral Audit

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Final Phd Exam Request Doctoral Audit

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REQUEST FOR FINAL DOCTORAL EXAMINATION
(One typed original must be submitted to the Graduate School three weeks prior to
examination date and by current semester deadline for graduation.)
Name:
LSU ID:!
Department/School:
Major:!
Minor:!
Exam Date:
Time & Place:
Has this Exam been Previously Scheduled?
Student Information
Suggested Committee
Note: Doctoral committees must include at least one full member of the graduate faculty from the major
department. All general exams will be assigned a dean’s representative. If you are including a
member of Southern University’s graduate faculty, indicate it with a (SU) after their name.
Typed/Printed Names
Chair: _______________________________
Dean Rep: ____________________________
Member: _____________________________
Member: _____________________________
Member: _____________________________
Signatures
Committee Chair: ________________________________________________
Chair, Head of Department, or Grad Advisor: ____________________________
Graduate Dean: ___________________________________________________
Title of Dissertation
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
For Office Use Only
GPA:
CW:
TIME:
REG:
COM:
Minor Prof: ___________________________
Updated: 1/11/2016
Yes
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Final Phd Exam Request Doctoral Audit

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Completed 21 June 2020

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