Thesis/dissertation Submission Form
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2University of Oregon Graduate School
THESIS/DISSERTATION SUBMISSION FORM
Page 1 of 2
You must submit both of these forms before your document will be reviewed.
Student ID Number: ______________________________________
Student Name of Record (as it appears in DuckWeb):
____________________________
__________________________________ _____________
Last (Family) Name
First Name
Middle Initial
Before submitting this form, you must have uploaded your thesis/dissertation to the UMI ETD site.
Date uploaded: ___________________________
Please specify the style manual or journal you used to format your in-text reference citations,
endnotes, or footnotes, and References Cited section:
________________________________________________________________________________________
Note: If you used anything other than APA, ACS, MLA, Chicago, or Turabian, you must provide a
copy of the citation/reference instructions from the manual/journal OR an article reprint from the
selected journal.
Does your document include co-authored and/or previously published material? Yes
No
Is any part of the body of your document formatted in the style of a journal?
Yes
No
If yes to either of these questions, did you submit a Content & Style Request form? Yes
No
Where can you be contacted during the next two weeks?
Phone: __________________________
Email: ______________________________________________
Address: ______________________________ __________________________ _______ _____________
Street
City
State
Zip
If you will not be available during the next two weeks after submitting your document, please
provide the name of the secondary contact person who will make your corrections:
Name: __________________________________________ Phone: _________________________________
Email: ___________________________________________________________________________________
Address: ______________________________ __________________________ _______ ____________
Street
City
State
Zip
What is your permanent mailing address?
Phone: __________________________
Email: ____________________________________________
Address: ______________________________ __________________________ _______ ____________
Street
City
State
Zip
Student Signature: ______________________________________________ Date: ________________
The Style Manual and completion procedures for graduate degrees are available online at:
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