Each student enrolled in the CSE Program should submit this form when nearing completion of a graduate degree program with the CSE Option. The completed form should be submitted to the CSE administrative office, 2270 DCL.
Date: ___________________________________________
Name: __________________________________________
UIN: ___________________________________________
NetID: __________________________________________
Graduation date: __________________________________
Employment and address information after graduation, if known:
Employer: _______________________________________________
Address: ________________________________________________
________________________________________________
Email: __________________________________________________
Major department: ______________________________________
Degree program (circle one): M.S. | Ph.D.
Courses taken to fulfill requirements of CSE Option:
Thesis title: __________________________________________________________________
___________________________________________________________________
List of thesis committee members (Ph.D. only; signatures not required)
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
Signature of student: _________________________________
Faculty advisor signature: _________________________________
(Advisor name PRINTED): _________________________________
Approval of departmental CSE representative: ___________________________________
Date: _________________________________
Comments:
Approval of CSE administrator: ___________________________________________
Date: _________________________________
Comments:
To be filed with the CSE administrative office, 2270 DCL