INDIVIDUAL PH.D. (IPhD) PROGRAM APPLICATION
UNIVERSITY OF WASHINGTON -- The Graduate School


Applicant Name:

                                                                                    

 UW Student #:                      
E-mail Address:                                                                                     Telephone #:                      
Mailing Address:                                                                                                                                         
                                                                                                                                        
Present academic unit:                                                                                                                                         
Last quarter at UW:                                                                                                                                          
Previous Degrees: Degree Field University

Year Awarded
                                                                                                                                                                
                                                                                                                                                                
                                                                                                                                                                
Proposed Field of Study:                                                                                                                             
Tentative Dissertation Title:                                                                                                                             

Proposed Supervisory Committee Statement
 We find that this proposed Individual Ph.D. Program is (1) a well-considered program not now provided for within the academic units authorized to offer a Ph.D. program at the University and is adequate preparation for the Ph.D. degree; (2) that the existing library, laboratory and research facilities are adequate for this special program; and (3) that the applicant is qualified to attempt the program.

We are willing to serve as a Supervisory Committee for the applicant's program and, if the application is approved, we accept the responsibility of conducting an annual review of the student's progress to be submitted to the Standing Review Committee in addition to ensuring that coursework, research requirements and the General and Final Exams are completed in a timely manner.

Name  

Department

Signature

Date
 
Chair:                                                                                                                                                        
Members:                                                                                                                                                         
                                                                                                                                                        
                                                                                                                                                        
                                                                                                                                                        

Please indicate members of the Graduate Faculty with an asterisk (*)

All the above information is complete and accurate and I have submitted an original proposal along with 10 copies of this application and 10 copies of the proposal by the deadline of February 1st.

                                                                                                                   
Applicant Signature
8/98 		Date