Fillable THESIS/DISSERTATION FACULTY COMMITTEE APPOINTMENT FORM (Committee members listed (University of Memphis)

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THESIS/DISSERTATION FACULTY COMMITTEE APPOINTMENT FORM (Committee members listed (University of Memphis)

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THESIS/DISSERTATION FACULTY COMMITTEE APPOINTMENT FORM
(Committee members listed below MUST have graduate faculty status at the time of form submission. Form will be returned to
Committee Chair if a member has not been approved for graduate faculty status.) This form is interactive.
Student’s Full Name: ______________________________________________________ Banner ID: U________________________
Current Mailing Address: _______________________________________________________________________________________
Street City, State Zip Code
Email Address: _______________________________________________________________________________________________
Degree:____________ Major: __________________________________________________________________________________
(Degree Abbreviation) (Please be accurate in your listing)
Area of Concentration (if applicable): ___________________________________________________________________________
FACULTY COMMITTEE APPOINTMENTS:
(Please print name)
_________________________________________________________________
Committee Chair
U of M Department Affiliation: _______________________________________
_________________________________________________________________
(Signature)
__________________________________________________________________
Committee Member
U of M Department Affiliation: _______________________________________
_________________________________________________________________
(Signature)
_________________________________________________________________
Committee Member
U of M Department Affiliation:________________________________________
_________________________________________________________________
(Signature)
_________________________________________________________________
Committee Member
U of M Department Affiliation:________________________________________
_________________________________________________________________
(Signature)
_________________________________________________________________
Committee Member
U of M Department Affiliation:________________________________________
_________________________________________________________________
(Signature)
ADD MEMBER(S) TO COMMITTEE:
(Committee chair must notify committee, graduate coordinator, and department chair of ALL changes.)
(Please print name)
_________________________________________________________________
Committee Member
U of M Department Affiliation: _______________________________________
_________________________________________________________________
(Signature)
__________________________________________________________________
Committee Member
U of M Department Affiliation: _______________________________________
_________________________________________________________________
(Signature)
_________________________________________________________________
Committee Member
U of M Department Affiliation:________________________________________
_________________________________________________________________
(Signature)
_________________________________________________________________
Committee Member
U of M Department Affiliation:________________________________________
_________________________________________________________________
(Signature)
Thesis/Dissertation Faculty Committee (Continued)
Student’s Full Name: _________________________________________________________________________________________ Banner ID: U_________________
REPLACE MEMBER(S) ON COMMITTEE:
(Committee chair must notify committee, graduate coordinator, and department chair of ALL changes.)
(Please print name)
Replace______________________________________________
Committee Member
With ____________________________________________
Committee Member
Replace______________________________________________
Committee Member
With ____________________________________________
Committee Member
Replace______________________________________________
Committee Member
With ____________________________________________
Committee Member
REMOVE MEMBER(S) FROM COMMITTEE:
(Committee chair must notify committee, graduate coordinator, and department chair of ALL changes.)
(Please print name)
_____________________________________________________________________
Committee Member
_____________________________________________________________________
Committee Member
_____________________________________________________________________
Committee Member
_____________________________________________________________________
Committee Member
DEPARTMENTAL/COLLEGE APPROVALS:
(Please sign name)
Graduate Coordinator:______________________________________________________________________ Date:______________
Department Chair:_________________________________________________________________________ Date:______________
College Director of Graduate Studies:__________________________________________________________ Date:______________
Vice Provost for Graduate Programs:__________________________________________________________ Date:______________
(or designee)
Revised: 10/27/10
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THESISDISSERTATION FACULTY COMMITTEE APPOINTMENT FORM (Committee members listed (University of Memphis)

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Completed 29 August 2020

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