Graduate Advisory Committee
The Committee will comprise the examining body for the student at the completion of the
course requirements. The Chair should be the Program Director but may, at the student’s
discretion, be selected from the faculty instructing industrial hygiene courses. At least three
members are required. The student is responsible for asking committee members to serve
and attaching verification from the committee members to this form, either as an e-mail or
written acceptance.
Do not return this form until it is complete. Failure to submit the form after twenty credits of
registration may cause a “hold” to be placed on your student account and prevent further
registration until the form is received by the Graduate Office.
Chair: ___________________________________________________
Member: ___________________________________________________
Member: ___________________________________________________
If, for some reason, the committee must be revised, please send a list of the revised
members to the Graduate Office at least one month prior to the final examination.
DUE: By the end of the completion of 20 online course credits.
Send completed form to the address shown below:
Graduate School
Montana Tech
1300 West Park St
Butte MT 59701
gradschool@mtech.edu
Graduate Office Official Use Only
REV: 10-29-18
