change of supervisor form

							University of Waterloo Graduate Studies Office Needles Hall, Room 2072 www.grad.uwaterloo.ca

CHANGE OF SUPERVISOR FORM

Name of Student: ______________________________________________________ ID:________________________ Date: _______________________________________ Faculty: ____________________________________ Terms in Program: ____________________________ Department: _________________________________

Degree Program:

Master’s (thesis) Master’s (coursework)

Ph.D. (from Master's) Ph.D. (direct admission from Bachelor's)

Change of Supervision Requested:

Change to a new supervisor

Add a co-supervisor Remove co-supervisor

Current Supervisor (please print): __________________________________________________________________ Date of termination of Research Assistant support from current supervisor(if applicable):_____________________________________________________________ New Supervisor/co-supervisor (please print): __________________________________________________________ Date of commencement of Research Assistant support from new supervisor(if applicable): _______________________________________________________________ Comments: ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________

Signature of Student: _______________________________________________________ Date: _________________

Approval Signatures: Current supervisor:________________________________________________________ Date: _________________ New supervisor/co-supervisor:_______________________________________________ Date: _________________ Graduate Officer:__________________________________________________________ Date: _________________ Associate Dean of Graduate Studies: __________________________________________ Date: _________________

It will be understood that the intellectual contributions of the current supervisor and the student to the research carried out by the student during the period of his/her supervision will be fully recognized in accordance with the intellectual property policies of the University of Waterloo. GSO 2006