Graduate School | Outside Examiner Request Form

Outside Examiner Request Form

Last Name:

First Name:

UA ID Number

Student Telephone Number:

Student E-Mail Address:

*Students are responsible for reserving a room for their exam/defense. We will not accept any requests that are incomplete.*

Date of Exam (Monday through Friday and not on a University holiday):

* Requests for dates withing two weeks of the end of the semester will be considered on a case-by-case basis, as the availability of faculty to serve as outside examiners is very limited due to a variety of reasons.

We strongly suggest you schedule your defense/exam outside of this two-week window. *

Time of the Exam (must be between the hours of 9 am and 5 pm):

Location of Exam (TBA/TBD not allowed):

Academic Program (Discipline):

Please select the type of exam:

Oral Comprehensive
Dissertation Defense
Oral Comprehensive and Dissertation Defense Combined

Proposed Dissertation Title:

Advisor Name and Phone Number:

Advisor Department and E-Mail Address:

Comments: