OFFICE OF GRADUATE STUDIES
Ph.D. DISSERTATION
COMMITTEE APPOINTMENT REPORT
This form is to be completed on formation of the Ph.D. dissertation committee and submitted to the Office of Graduate
Studies, Fenster Hall, Suite 140. The committee must be formed within one year after the passing of the qualifying examination.
Committee members must meet the criteria for membership specified in the on-line NJIT graduate catalog.
Additionally, please check the Guidelines for Graduate Faculty at NJIT.
This appointment report must be submitted to the Graduate Studies Office before scheduling the Research Proposal
Defense.
Name of Doctoral Candidate
Last First
Ph. D. Program
Preliminary Title of Dissertation
Date of Committee Appointment
DISSERTATION COMMITTEE INFORMATION
Dissertation Advisor or Co-Advisors:
Name Department/Affiliation Rank
Print Signature
Print Signature
Members of Dissertation Committee:
Name Department/Affiliation Rank
Print Signature
Print Signature
Print Signature
Print Signature
Print Signature
Print Signature
Doctoral Program Director
Print Name Signature Date
Department Chair
Print Name Signature Date
Graduate Studies
Print Name Signature Date
I.D. #
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PhD Committee Appointment Report
Updated DT 4/2/2018
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