Committee Membership Form - Date Member(please print or...

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CSPP-LA at Alliant International University Clinical PhD Program Committee Membership Form The signatures below reflect the agreement of all parties involved with the selection of  the Dissertation Committee. _________________________ ____________________ _________ Student (please print or type) Signature Date _________________________ ____________________ _________ Chairperson (please print or type) Signature Date _________________________ ____________________ _________ Member (please print or type) Signature
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Unformatted text preview: Date _________________________ ____________________ _________ Member (please print or type) Signature Date _________________________ ____________________ _________ Optional Member (print or type) Signature Date ___________________________ _______________ Signature of Program Director Date Procedure: Submit completed request to Program Office – Program Office will distribute Distribution: Original – Program Office Copies: Student, Chair, & Members...
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  • Spring '10
  • Admin
  • Program Director, dissertation committee, Alliant International University, Program Office, _________ Signature Date

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Committee Membership Form - Date Member(please print or...

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