Revised 09/12/2019
Request to Delay Qualifying Exam
STUDENT INFORMATION:
Student Name:
Research Advisor:
Email Address:
Date Submitted:
Proposed Research Area:
DEGREE AREA:
QUALIFYING EXAM COMMITTEE:
Advisor’s Nominee:
Student’s Nominee:
Dean’s Nominee:
(assigned by CHD)
1. Please explain your reasons for requesting the extension (required)
2. Month and year in which you expect to take the exam:
Advisor’s Comments (required):
Student Signature
Date
Advisor Signature
Date
Applied Math
Applied Physics
Computer Science
Engineering Sciences:
BIO
EE
ESE
Mat/Mech
