Integrative Dissertation Pro Seminar Applications

First Name

Last Name

NDID

Email Address

Telephone Number

Faculty Advisor Name

Faculty Advisor Email

Faculty Advisor Telephone Number

Current Degree Program

Month/year admitted or to be admitted to candidacy

Letter of Interest

Faculty Statement

Current CV/Resume

Statement of Acknowledgement
I have read and understand the conditions and expectations of the Integrative Dissertation ProSem as explained in the current "Information and Call for Applications." I affirm that I will participate in the program activities and complete the program next year and that I am a Ph.D. student in good academic standing. I also affirm that I have discussed the program with the appropriate faculty in my program of study and that they support my participation in the program, if selected. I understand that this application will be available only to qualified people who need to see it in the course of their duties. I affirm that all of this application, including the letter of interest, is my own work or formally cited from other sources. I affirm the information contained herein is true and accurate to the best of my knowledge and belief.

Signature (please type your name below in acknowledgement of your understanding)

Date