Extension Request Form Extension Request Form Multipart Step RequestName*Student ID*Email Address* Approximate Date of Program Entry* Date Format: MM slash DD slash YYYY Current Program Completion Deadline* Date Format: MM slash DD slash YYYY If you have not been given an updated deadline by the department, you can calculate your completion deadline by adding six years to your date of program entry.Approximate Date of RES8001 Completion* Date Format: MM slash DD slash YYYY On which component are you currently working?*Qualifying PaperDissertation ProposalDissertationRequested Deadline for Qualifying Paper Defense Date Format: MM slash DD slash YYYY Please suggest a specific deadline by which to successfully defend the Qualifying Paper. If you have already completed the QP, you can leave this blank.Requested Deadline for Proposal Defense Date Format: MM slash DD slash YYYY Please suggest a specific deadline by which to complete the proposal defense. If you have already successfully completed the proposal, you can leave this blank.Requested Deadline for Final Dissertation Defense* Date Format: MM slash DD slash YYYY Please suggest a specific date for intended completion of the Final Dissertation.Who are your assigned committee members?*Committee Chair Email Address* Justification for Extension Request*Documentation to Verify Circumstances (Optional) Drop files here or Accepted file types: pdf. Depending on the nature of your extenuating circumstances, please provide documentation and/or verification.First and Last Name*By entering your first and last name, you confirm that the information you have entered is accurate.Date* Date Format: MM slash DD slash YYYY Form ResponseYour Name*How would you like to respond?*ConfirmDeclineMore information requested**If you select "More information requested", note that you will need to eventually click the "Respond to this Request" link in the original request again in order to re-gain access to this form and provide your eventual response of Confirm or Decline.CommentsComments will be received by both department staff AND the requesting student.