________________________ __________
RECEIVED BY DATE
GS-QE 07/2012
ALABAMA A&M UNIVERSITY
School of Graduate Studies
Normal, Alabama 35762
Post Office Box 998
Telephone: (256) 372-5266
QUALIFYING/PRELIMINARY EXAMINATION APPLICATION
FOR PhD STUDENTS
__________________________ __________________________ __________________
Last Name First Name Student Number
________________________ ____________ ____ _________ __________________
Mailing Address City State Zip Code Telephone Number
_____________________________________ ________________________________
E-mail Major
Please choose the semester and year you wish to take the Qualifying Examination:
Fall Summer Spring __________
YEAR
_________________________________ ____________
Signature Date
---------------------------------- Graduate Office Use Only -----------------------------------
Planned Degree Plan Program on file:
Yes No
GRE & Remedial Courses: GRE GRE/ENG500 GRE/ENG500/MTH107(500)
Deficiency courses completed: Yes No
50% of Graduate Work Completed: Yes No Hrs. comp _______ GPA________
Incomplete course(s) grade(s): Yes No
Eligible:
Yes No
Not Eligible Because: __________________________________________________________
______________________________________________________________________________
___________________________________
Signature of Graduate School Official
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ALABAMA A&M UNIVERSITY
School of Graduate Studies
NOMINATIOIN TO THE GRADUATE FACULTY
NOMINEE:
___________________________________ ______________________________________
LAST NAME, FIRST NAME DEPARTMENT/SPECIALIZATION
__________________________________________ ______________________________________
TITLE ORGANIZATION
________________________ ______________________ _______________________________
TELEPHONE FAX E-MAIL
_____________________________________ _____________________________ ___________
TERMINAL DEGREE UNIVERSITY DATE
NOMINATION:
New Renewal
(check all that apply ) Full Time Part Time Cooperator
FOR THE PURPOSE OF:
Teaching graduate courses
Advising graduate student(s) as a member of their thesis/dissertation
committee(s)
THE FULL MEMBERS OF THE GRADUATE FACULTY OF THE DEPARTMENT SUBMIT THE
NOMINEE AS QUALIFIED FOR THE CLASSIFICATION OF:
FULL MEMBER ASSOCIATE MEMBER SPECIAL MEMBER
(5 years) (3 years) (Specific to duration of task)
___________________________ ________ __________________________ _____________
NOMINATOR DATE GRADUATE COORDINATOR DATE
___________________________ ___________ _________________________________ _________________
DEPARTMENT CHAIRPERSON DATE ACADEMIC DEAN DATE
NOTE:
1. Non-AAMU faculty/scientists/specialists are only eligible for Special Member Status.
2. For new appointments, attach a current vita and copy of terminal degree diploma.
3. For renewal appoint, attach a list of publications, which appeared in the past 4(four) years.
-------------------------------------------------- FOR GRADUATE OFFICE USE ONLY ---------------------------------------------------------
Approved FULL MEMBER ASSOCIATE MEMBER SPECIAL MEMBER
Not Approved
Incomplete Application ___________________________________ _____________________
Does not meet requirements FOR THE PERIOD DATE OF ACTION
__________________________________________ _____________________________________________
CHAIR, CREDENTIALS COMMITTEE DEAN, SCHOOL OF GRADUATE STUDIES
Distribution after action: Academic Dean, Department Chair, Nominee/Nominator
Revised 07/2012