Record of Completion Requirements for Doctoral Degree INTAKE Form

IMPORTANT: This form is for use by all Doctoral programs at MIU EXCEPT the PhD in Management in China program.

This "Record of Completion Requirements for Doctoral Degree INTAKE form" should be filled out and submitted by the chair (or other member) of the doctoral student's dissertation committee, the Program Director, or someone else positioned to report on completion of their dissertation and oral defense.

After submission, all affected parties will be emailed the official "Record of Completion Requirements for Doctoral Degree" form by the Registrar's office.

Each party will be asked to fill in certain form fields and/or submit their e-signatures.

When all form information and e-signatures have been collected, each affected party, including the doctoral student, as well as the library director, will be emailed a final, completed copy of the form for their information and records.

Any questions or concerns? Email registrar@miu.edu.

"*" indicates required fields

Name of Person Completing This Form*

First Last

Title and Department of Person Completing This Form*

Email of Person Completing This Form*

Doctoral Student Name*

First Last

Doctoral Student ID*

Doctoral Student (Preferred) Email*

Doctoral Program Name*

EdD in Transformational Leadership and Coaching

PhD in Maharishi Vedic Science

PhD in Management (Domestic)

PhD in Physiology and Health

PhD in Regenerative Organic Agriculture

Semester*

Fall

Spring

Year*

Dissertation Title*

Date Oral Defense Approved*

Date Written Dissertation Formally Accepted*

Is this student recommended for degree conferral in their program?*

Yes

Chairperson Name*

First Last

Chairperson Email*

work email only

Committee Member 1 Name*

First Last

Committee Member 1 Email*

work email only

Committee Member 2 Name*

First Last

Committee Member 2 Email*

work email only

Committee Member 3 Name (if applicable)

First Last

Committee Member 3 Email (if applicable)

work email only

Committee Member 4 Name (if applicable)

First Last

Committee Member 4 Email (if applicable)

work email only

Program Director Name*

First Last

Program Director Email*

work email only

(OPTIONAL) If there is a person(s) (not already listed on this form) for whom you believe a completed copy of the "Record of Completion Requirements for Doctoral Degree Form" should be sent after all parties have filled and signed it, please list the following info about them below: 1) NAME (FIRST LAST) 2) EMAIL 3) PHONE 4) ACADEMIC RELATIONSHIP TO THE DOCTORAL STUDENT/JUSTIFICATION FOR RECEIVING THIS COMPLETED FORM. If the Registrar deems it academically necessary and in accordance with FERPA regulations for this person(s) to receive a completed copy, it will be done. NOTE: If the person filling out this INTAKE form, i.e YOU, is not already set to get a completed copy of the final form, you will be sent one as well.

Current Students

Current Students

Current Students

Record of Completion Requirements for Doctoral Degree INTAKE Form