Ohio University

 Application  for New Delivery Format or Location
of a Previously-Approved Graduate Program Signature Form

This form is designed to be filled out online and then printed so that the signatures can be added.

 

Department and/or Campus Name:
(separate with a comma)

Degree:                                             

Delivery Format and/or Location:   
(separate with a comma)

Date (MM/DD/YYYY):                              

Delivery Approaches for Previously-Approved Graduate Programs

 Submitted by

Name of Program Coordinators/Advisors:

Typed Name:       Phone No.:

E-Mail:             Campus Address:

Signature:    ______________________________________________________________

Date: _____________________


Typed Name:       Phone No.:

E-Mail:             Campus Address:

Signature:    ______________________________________________________________

Date: _____________________




  Graduate Chair:  

   Signature:    ______________________________________________________________ Date: _____________________

   Proposal Endorsements

   Chair/Director/Department/School:

   Typed Name:

    Signature:    ______________________________________________________________ Date: _____________________

    Dean, College

    Typed Name:

   Signature:    ______________________________________________________________ Date: _____________________

    Chair, Graduate Outreach Committee:

   Typed Name:

    Signature:    ______________________________________________________________ Date: _____________________

 

 

 

  APPROVAL    Dean, Graduate College:

   Typed Name:

   Signature:    ______________________________________________________________ Date: _____________________

 

MAIL or FAX the pages of this form (or e-mail a PDF version) and your support documentation to:

Kim Hayden, Administrative Coordinator, University Outreach,
Haning Hall 131, Ohio University, Athens, OH 45701-2979
hayden@ohio.edu
FAX: 740-593-2867

 

Revised 5/11/09

 

 

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