1/21 GS This form is available on the Graduate School website
PORTLAND STATE UNIVERSITY PLEASE SUBMIT A SINGLE COPY
DOCTORAL
DISSERTATION SIGNATURE PAGE
Student _____________________________________________________________ PSU ID # ____________________
Degree _________________________ Major ______________________________________________
Date of dissertation defense _______________________________
The dissertation committee and doctoral program approve the final, post-defense version of
this student’s doctoral dissertation.
Dissertation Chair
print name
signature
date
Committee Members
print name
signature
date
print name
signature
date
print name
signature
date
print name
signature
date
print name
signature
date
Doctoral Program Approval
print name
signature
date
By signing this form, I confirm that the dissertation I submit to the Graduate School is the final, post-defense
copy of my dissertation that has been approved by my committee. I understand that submitting an alternate
version of my dissertation to the Graduate School may be a violation of the PSU Student Code of Conduct
and may result in sanctions up to and including revocation of the degree.
student signature
date