ARKANSAS TECH UNIVERSITY
DISSERTATION PROPOSAL DEFENSE REPORT
This form should be completed and filed with the Graduate College after the dissertation proposal
defense is completed.
STUDENT NAME: _______________________________________________ T NUMBER: _____________________________
EMAIL ADDRESS: ________________________________________________________ DATE: __________________________
DISSERTATION TITLE:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
DATE OF DEFENSE: _________________________________________________________________________________________
DISSERTATION PROPOSAL DEFENSE: ☐ PASSED ☐ FAILED
SIGNATURES OF DISSERTATION COMMITTEE MEMBERS:
________________________________ ________________________________ _______________ ☐ PASSED ☐ FAILED
CHAIR NAME (PRINT) SIGNATURE DATE
________________________________ ________________________________ _______________ ☐ PASSED ☐ FAILED
COMMITTEE MEMBER (PRINT) SIGNATURE DATE
________________________________ ________________________________ _______________ ☐ PASSED ☐ FAILED
COMMITTEE MEMBER (PRINT) SIGNATURE DATE
________________________________ ________________________________ _______________ ☐ PASSED ☐ FAILED
COMMITTEE MEMBER (PRINT) SIGNATURE DATE
________________________________ ________________________________ _______________ ☐ PASSED ☐ FAILED
COMMITTEE MEMBER (PRINT) SIGNATURE DATE
SIGNATURES OF APPROVAL:
_____________________________________________________________________________________ ___________________________
Program Director Date
_____________________________________________________________________________________ ___________________________
Dean of the Graduate College Date