Committee Selection

Name*

First Middle Last

Phone*

Email*

Please provide the details of your proposed research topic.*

Please describe your proposed methodology.*

All committee members must be approved Ph.D. faculty from the Global Leadership program and must include a minimum of the following:

1. Chair – Must be a faculty member possessing a doctoral degree at Indiana Tech within your related discipline/Dissertation topical area.

2. Second Member – Strong research faculty member possessing a doctoral degree, either qualitative or quantitative depending on your Dissertation methodology

3. Third Member – This individual may be someone from inside the PhD department or another department at Indiana Tech, must have a doctoral degree, and must have extensive knowledge within your general research discipline.

Any faculty member listed as an option within the Committee Chair and Committee Member drop boxes is currently available to be requested for that role. If he or she does not appear as an option, he or she is not currently available to be requested for that particular role at this time.

***Please note that if a faculty member is already assigned to your committee YOU DO NOT NEED TO RE-REQUEST THEM when requesting additional members. In such cases, you may leave that section (for example, the Select Chair section) blank. The form will still process even if all three sections aren’t populated.***

Committee Chair

Select Chair

This request is for a replacement of the committee chair.

Who is the new committee chair replacing?*

Has the previous committee chair been notified of this change?*

Yes
No

Committee Member 1

Select Committee Member

This request is for a replacement of a committee member.

Who is the new committee member replacing?*

Has the previous committee member been notified of this change?*

Yes
No

Committee Member 2

Select Committee Member

This request is for a replacement of a committee member.

Who is the new committee member replacing?*

Has the previous committee member been notified of this change?*

Yes
No

Confirmation

Once you’ve submitted this form, your selected committee chair or member(s) will be contacted automatically and asked to confirm your request to include him or her on your committee.

First and Last Name*

By entering your first and last name, you confirm that the information you have entered is accurate.

Date*

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