Health Professions Division Dissertation Guide

56 Appendix F Appointment of Dissertation Committee Form Nova Southeastern University Doctor of Philosophy Program (insert individual Program) APPOINTMENT OF DISSERTATION COMMITTEE FORM Candidate’s Name: ID#: N Step 1: Dissertation Committee formed with the following DissertationCommitteeChair&Second member: Dissertation Committee Chair (Print) Signature Date 2 nd Member (Print) Signature Date Step 2: Dissertation Committee third member: 3 rd Member (Print) Date Rationale for third member & CV submitted to Program Director Date Step 3: Full Dissertation Committee approved on this ______ day of ____________ (month, year) by the Committee Chairperson and the Ph.D. Program Director. Dissertation Committee Chair Ph.D. Program Director