Request for Committee Member Change Form

Contact Kate Ryan, Graduate Program Coordinator, at cryan7@wisc.edu with questions about this form.

"*" indicates required fields

Student Name*

Date of Request*

List your current thesis committee members*

List your Thesis Advisor first, then click the + to add more committee members.

Indicate which committee member(s) is being replaced with whom*

Click the + to add more committee members.

Replacing

With

Reason for change(s)*

Name

This field is for validation purposes and should be left unchanged.