School of Dental Medicine - University of Pittsburgh



8001038100Completed form is to be submitted by the student to the Oral Biology Graduate Studies Committee 020000Completed form is to be submitted by the student to the Oral Biology Graduate Studies Committee MS Thesis Committee Approval Form113347595885[Replace with Text]020000[Replace with Text]Candidate’s Name: Candidate’s Signature: ___________________1831975124460[Replace with Text]020000[Replace with Text]Anticipated Graduation Date: 1390015132715[Replace with Text]020000[Replace with Text]Proposed Thesis Title: Proposed Thesis Committee:Major Thesis Advisor_____________________ Name (print) Oral Biology Faculty Committee Member Oral Biology Faculty Committee Member_____________________ _____________________ Name (print)Name (print)Oral Biology or Outside Faculty Committee Member*_____________________ Name (print)*if the committee member has a primary appointment from another university, pre-approval must be sought from the UPSDM Senior Associate Dean. Please attach evidence of this approval to this form.-90805153035Approved, Chair, Graduate Studies Committee_____________________ _______________________ _____________________Name (print) Name (Sign) Date020000Approved, Chair, Graduate Studies Committee_____________________ _______________________ _____________________Name (print) Name (Sign) Date ................
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