Form Go-16d - Appointment Of Doctoral Dissertation Committee
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1APPOINTMENT OF DOCTORAL DISSERTATION COMMITTEE
The doctoral program must submit this form to the Office of Graduate Studies with the names of two eligible faculty members for
consideration as Graduate Office Representative. The Office of Graduate Studies will give first consideration to the recommendations but
reserves the right to choose another faculty member.
The dissertation committee must consist of four to six PSU faculty members: the dissertation chair, a minimum of two and a maximum of
four regular members, and the Graduate Office Representative. The chair of the dissertation committee and the Graduate Office
Representative must be regular, full-time PSU instructional faculty, tenured or tenure-track, assistant professor or higher in rank; the other
two to four committee members may include adjunct or fixed-term faculty and/or members of the OHSU faculty. If it is necessary to go off-
campus for one committee member with specific expertise not available among PSU faculty, a curriculum vitae (CV) for that proposed
member must be presented with the GO-16D form. This off-campus member may substitute for one of the two to four regular committee
members. All committee members must have doctoral degrees.
At the discretion of the program, the designation of co-chair can be requested for one regular member of the committee. The designation of
co-chair recognizes the significant academic advising role of the committee member, but oversight of the process and procedures remains
with the chair. To request this designation, write “co-chair” below next to the appropriate faculty member’s name.
Students must be registered for a minimum of 1 graduate credit in the term they are defending their dissertation proposal.
THE DISSERTATION COMMITTEE MUST BE APPROVED BY THE OFFICE OF GRADUATE STUDIES
BEFORE THE PROPOSAL DEFENSE.
Any committee changes, for any reason, must be approved in advance by the Office of Graduate Studies.
Name _____________________________________________________________ PSU ID# _____________________________
PSU E-mail (print clearly)_____________________________________________ Daytime phone _________________________
Degree (Ph.D., Ed.D.) ____________________ Major ____________________________________________________________
Dissertation title or topic ____________________________________________________________________________________
Will Human Subjects be involved in any way?
Yes
No (must select one)
Estimated date of proposal defense __________________ Do not schedule proposal without OGS approval of the committee.
COMMITTEE MEMBER
DEPARTMENT
Chair:
_____________________________________________________
______________________________________
_____________________________________________________
______________________________________
_____________________________________________________
______________________________________
_____________________________________________________
______________________________________
_____________________________________________________
______________________________________
_____________________________________________________
______________________________________
Submit two suggestions, in priority order, for consideration for Graduate Office Representative
________________________________________________________
________________________________________
________________________________________________________
________________________________________
NO PROPOSAL DEFENSE SHALL BE VALID WITHOUT A DISSERTATION COMMITTEE APPROVED BY
THE OFFICE OF GRADUATE STUDIES.
_____________________________
___________________________________________
___________
________
Dissertation Chair (printed name)
Dissertation Chair (signature)
Date
______________________________
___________________________________________
___________
_______
Doctoral Program Director (printed name)
Doctoral Program Director (signature)
Date
To be completed by the OFFICE OF GRADUATE STUDIES
Graduate Office Representative ________________________________________________
__________________________
Name
Department
Dean of Graduate Studies _____________________________________________________ Date ______________________
This form is available on our website:
11/15 OGS
GO-16D
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