Fillable Rsrc Requestto Schedule Dissertation Defense (Arkansas Tech University)

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Rsrc Requestto Schedule Dissertation Defense (Arkansas Tech University)

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ARKANSAS TECH UNIVERSITY
REQUEST TO SCHEDULE DISSERTATION DEFENSE
This form should be completed and filed with the Graduate College.
STUDENT NAME: _______________________________________________ T NUMBER: _____________________________
EMAIL ADDRESS: ________________________________________________________ DATE: __________________________
DEPARTMENT/PROGRAM: _______________________________________________________________________________
DISSERTATION TITLE:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
DATE OF DEFENSE: ___________________________________ TIME OF DEFENSE: _____________________________
LOCATION OF DEFENSE: ___________________________________________ , _____________________________________
Building Name Room Number
SIGNATURES OF DISSERTATION COMMITTEE MEMBERS:
___________________________________________ ___________________________________________ ________________________
CHAIR NAME (PRINT) SIGNATURE DATE
___________________________________________ ___________________________________________ ________________________
COMMITTEE MEMBER (PRINT) SIGNATURE DATE
___________________________________________ ___________________________________________ ________________________
COMMITTEE MEMBER (PRINT) SIGNATURE DATE
___________________________________________ ___________________________________________ ________________________
COMMITTEE MEMBER (PRINT) SIGNATURE DATE
___________________________________________ ___________________________________________ ________________________
COMMITTEE MEMBER (PRINT) SIGNATURE DATE
SIGNATURES OF APPROVAL:
_____________________________________________________________________________________ ___________________________
Program Director Date
_____________________________________________________________________________________ ___________________________
Dean of the Graduate College Date
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Rsrc Requestto Schedule Dissertation Defense (Arkansas Tech University)

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Completed 18 July 2020

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