Dissertation Advisor Selection Form

NYU Chemistry

Dissertation A dvisor S election F orm

Please i ndicate y our f irst a nd s econd c hoices f or D issertation A dvisor. P lease h ave

your f irst c hoice p otential a dvisor s ign t his f orm i ndicating h is/her w illingness a nd

commitment t o a ccept y ou i nto h is/her g roup.

Note to faculty: Your signature on this form indicates your commitment to

accept this student to your group including available space and available funding

sources.

Last N ame: _ _____________________ F irst N ame: _ ______________________

NYU I D: _ N________________________ E mail: _ ______________@nyu.edu__

First C hoice

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F aculty N ame ( Printed)

Faculty S ignature

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Date

Second C hoice:

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F aculty N ame ( Printed)

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