Thesis or Dissertation Defense
(To be completed and led after the defense)
Date:
Department:
Student ID Number:
Student Name:
College:
Degree:
Advisor:
Thesis/Dissertation Title:
ID Number:
If thesis/dissertation completed successfully, sign below.
Program Director
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.
Signatures of Committee Members:
Chair:
Member:
Member:
Member:
Member:
Member:
Member:
Member:
The above-named candidate has been examined by the committee with the following results:
The above-named candidate has successfully completed the nal version of the thesis or dissertation:
Passed:
Passed:
Failed:
Failed:
12/16
SUBMIT
SUBMIT
SUBMIT
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