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PhD Graduate Program Guide

Application for the Formation of PhD Committee

Name __________________________________________ Date: ___________
  Last                                 First                           MI
Address __________________________________________ ID: _____________
Email __________________________________________________________
Reearch Areas [1] __________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________

APPROVALS [2]

Candidate's Signature : _______________________________ Date : _______________
Supervising Committee SignaturesTyped NameDate
Supervising Professor [3] ____________________ _______________________ _________
Member ____________________ _______________________ _________
Member ____________________ _______________________ _________
Member ____________________ _______________________ _________
Member ____________________ _______________________ _________
Member ____________________ _______________________ _________

________________________ __________ ___________________ ________
Committee on Graduate Studies Date Graduate Advisor Date
________________________ __________  
Chairman Date

[1] List at least five topics/subjects in Computer Science or other Field that are relevant to your research interests
[2] By signing this form a committee member agrees to serve on the PhD student's Dissertation Committee. The student is expected to discuss his/her interests and committee member responsibilities with the member when seeking approval.
[3] If you have a co-supervisor then underline his/her name.

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