UW-Milwaukee Graduate School |

The University of Wisconsin-Milwaukee Graduate School
Application for the Doctoral Dissertation Defense and Graduation
Clearly TYPE or PRINT all information. Your name on the diploma will be printed as it exists on your university records. Changes to your name must be made in Mellencamp 274 at least one month prior to graduation. All italicized information will appear in the commencement program.
*First Name:
Middle Name or Initial:
*Last Name:
*Student ID:
*Street:
*City:
*State:
*Zip:
*Phone:
*E-mail Address:
*Doctoral Program:
Minor Option A (if applicable):
Major Professor (or Co-Chairs):
*Expected Graduation Date:
Dissertation Title:
A minimum of 5 graduate faculty members, including the major professor, are nominated to serve on the student's dissertation defense committee as follows:
Committee Members:	* *
	* *
	*