ADMINISTRATIVE APPROVAL REQUEST FORM
Submit the ORIGINAL FORM and CURRENT VITA
Name of Nominee _______________________________ Department _________________________
LSUID ___________________________ College __________________________
Signature of Nominee (if serving on a committee) __________________________________________
A. COURSE APPROVAL
Course(s) for which the nominee seeks approval to teach:
TERM YEAR DEPT _______________________
1s CRS ________________________
2s CRS ________________________
3s CRS ________________________
OR 3-year CRS ________________________
B. COMMITTEE APPROVAL
The nominee seeks approval to serve on a graduate committee(s) as (check one of the following):
Chair* __________ Committee Member* __________ (to count in the minimum)
Co-Chair* __________ __________ (not to count in the minimum)
*If you are requesting for the nominee to be counted in the minimum, please attach a strong justification.
List the N
AME(S) as enrolled and LSUID(S) of students on whose committees the nominee seeks to serve:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Please present a rationale for this administrative approval request (use additional pages if necessary):
Department Chair: _______________________ Signature _____________________ Date _____________
(Please type/print)
College Dean: __________________________ Signature _____________________ Date _____________
(Please type/print)
Please forward to The Graduate School upon approval.
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Date Received by Graduate School ____________________ Added to Database __________________
Graduate School Dean: ____________________ Signature ____________________ Date _____________
TGS July/2011