Choice of Graduate Faculty Committee Form Student ID Graduate

Choice of Graduate Faculty Committee Form
Department of Chemistry – Eastern Kentucky University
Student _________________________________
ID ____________________
Graduate Program Coordinator _______________
Date __________________
THESIS OPTION: Interview each faculty member about his/her research program. After each interview, request the
faculty member to sign. Once interviews are complete, determine the faculty member that could be a potential
advisor to discuss possible projects and ensure he/she is willing to supervise the project as faculty mentor.
INTERNSHIP OPTION: If an internship will be completed, interview each faculty member that would be willing to
meet about the progress with the internship experience. One faculty will need to serve as the Faculty Mentor /
Committee chair. It is highly encouraged to have one member from the host organization to serve on the committee.
COURSEWORK OPTION: If the coursework is chosen, a faculty committee will be needed in the final semester of
the graduate program to review a student’s curriculum to prepare a written and oral exit examinations.
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*Faculty Member –
*Faculty Member –
*Faculty Member –
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*Faculty Member –
*Faculty Member –
*Faculty Member –
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*Faculty Member –
*Faculty Member –
*Faculty Member –
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*Faculty Member –
*Faculty Member –
*Faculty Member –
*Print Last Name (after dash) and then signature above
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Choice of Graduate Faculty Mentor (Print Name): _________________________________________
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Graduate Student Signature/Date
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Graduate Faculty Mentor Signature/Date
Program Coordinator Signature/Date
------------------------------------------------------------------------------------------------------------------Chemistry Graduate Committee! (To be completed after finalizing the above information)
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Committee Chair (Faculty Mentor)
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Committee Chair Signature/Date
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Committee Member
Member Signature/Date
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Committee Member
Member Signature/Date
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Committee Member
Member Signature/Date
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Committee Member
Member Signature/Date
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The student must determine a faculty
mentor with one additional committee
member (where faculty mentor will serve as
committee chair). The Graduate Program
Coordinator will appoint a third committee
member. If performing an internship, it is
highly encouraged to have a fourth member
from the host organization (if possible).
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Graduate Program Coordinator Signature/Date
__________________________________
Department Chair Signature/Date
Return this form to the Graduate Program Coordinator by ________________.
Original to: Student file
Copies to: Student, Faculty Mentor, Graduate Program Coordinator
Rev 01/2015