REPORT OF DOCTORAL COMMITTEE COMPOSTION by elf15161

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									                REPORT OF DOCTORAL COMMITTEE COMPOSITION

                                                        Please Print Clearly


Last Name                               First Name               Middle Initial                 Student ID #


Expected Graduation                 Tel #                      Email Address                      Department

Dissertation Topic:




                      Doctoral Committee                                             Department
                Committee Member Names
                        (please print full name)

1.
                      Committee Chair
2.

3.

4.

5.

                Graduate School Appointee
            (to be completed by School of Graduate Studies)

6.


                                                   Committee Chair
                                                                                  (Signature)           Date

                                    Dean of Graduate Studies
                                                                                  (Signature)           Date

                            Form to be submitted to School of Graduate Studies when completed
                                     GRADUATE SCHOOL USE ONLY

Date Received

Initials


           North Carolina A & T State University * School of Graduate Studies * 120 Gibbs Hall * Greensboro, NC 27411

								
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