Registered with Graduate School

Today's Date

mm/dd/yyyy

Student's name

Student's US mail address:

Student's email address:

Name of department granting student's degree (e.g. EFR, EDL, T&L)

Degree sought (EdD or PhD)

Adviser's name

Adviser's email address

Type of comp (Foundations or Research)

Date exam is due back by email to EFR Grad Director

mm/dd/yyyy