Request to Change Thesis or Dissertation Advisory
Committee Member
Date:
Department:
Student ID Number:
Student Name:
College:
Graduate Program
Director Signature:
Chair Signature:
College Dean Signature:
Form must be submitted to the Ofce of Admissions, Records and Registration after electronic signatures are completed.
Please ensure any relevant additional documentation is attached to the generated email.
Signature:
Previous Committee
Advisor or Member:
(Please type name)
ID Number: Date:
Signature:
Previous Committee
Advisor or Member:
(Please type name)
ID Number: Date:
Signature:
Proposed Committee
Advisor or Member:
(Please type name)
ID Number: Date:
Signature:
Proposed Committee
Advisor or Member:
(Please type name)
ID Number: Date:
12/16
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