mockqualform by VISAKH


									                         Mock Qualifying Exam Request Form


Date, time, and location of actual Qualifying Exam:

Date range of when you would like the Mock Qualifying Exam (should be between 2
weeks and 3 days before the actual exam):

Members of your real committee:
     Other Members:

List any students and post docs you would like to have on your mock committee. If any
of the students are outside our department, please give their contact information.

Is there anything you want the mock committee to focus on during your mock exam?
  (i.e. any subject in which you feel unconfident)

To help ensure a productive Mock Qualifying exam one member of the GSA who has
already passed their exam will sit in on your exam as the “Chair.” They will be in charge
of leading the mock exam. The students who are available are:

                       Jonas King             John Gibbons
                       Jenifer Ferguson       Dan Erickson
                       Diane Kanter           Charlene Hawkins

If you have a preference as to who is your “Chair” please list here: ________________

Request Form checklist:
---completed form
---attached abstract of proposal (this is important so that students can get a general idea
about your research).
---you will need to submit your proposal to your Mock Committee at least two days
before your mock exam.

*Any information you provide will be kept strictly confidential.
The GSA wishes you the best and if there is anything else I can do for you, just email me.

Be sure to email your completed request form to

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