Thesis Dissertation AcceptanceForm

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Submit Form to: etdsvcs@utoledo.

edu (digital signatures accepted) OR RETURN TO:


College of Graduate Studies
Main Campus Health Science Campus
University Hall Room 3240 Mulford Library Room 113
Mail Stop 933 Mail Stop 1042

Acceptance of Thesis or Dissertation for Defense


Instructions: Students with a thesis or dissertation requirement must obtain the signature of their Advisor/Committee
Chair for approval to present/defend their paper. The form must contain the date, time, building and room number of your
scheduled defense. The Associate Dean of your college must sign to grant the College of Graduate Studies permission to
publicize the defense on their website. The form can be filled out and signed electronically and forwarded to each
signatory for their signature for delivery to the email address above, or you may print it out, obtain the signatures, and
submit it hard copy. This form is due in the Graduate Studies office no later than fifteen (15) business days prior to your
scheduled defense. Forms received less than fifteen (15) business days prior to the defense date will not have the
defense information included on the College of Graduate Studies website. If the defense will include any proprietary or
potentially patentable subject matter, it should not be open to the public and should not be advertised as such. This form
must accompany the Intellectual Protection and Patent Sign-off form.

Name: ___________________________________________________________________ Rocket ID: __________________________

Degree: __________________________________________ Program: ___________________________________________________

Title:

Date:_____________________ Time:__________________ Building:___________________________ Room:___________

I hereby certify that the above titled document is my original work and I am seeking approval to defend this work in partial satisfaction of
my degree requirement. I also certify that I completed the Intellectual Protection and Patent Sign-off form and it accompanies this form.

___________________________________________ ________________________________
Student’s Signature Date

I hereby certify that the defense of the above titled thesis/dissertation will not include any proprietary or potentially patentable subject
matter and is acceptable to be open to the public: YES NO

I hereby certify that I have read the above titled thesis/dissertation and it is my judgement that it is a contribution to knowledge of
importance sufficient to qualify it for defense, but does not constitute final approval of the thesis/dissertation.

___________________________________ __________________________________ ____________


Advisor/Committee Chair (Printed) Signature Date

I authorize the publication of the defense of the above titled document on the College of Graduate Studies website: YES NO

___________________________________ __________________________________ ____________


Associate Dean, Degree Program (Printed) Signature Date

COLLEGE OF GRADUATE STUDIES USE ONLY

Received by: _______________________________ Date: __________________ IPPSO received: YES or NO (circle one) Date: ____________

Publicize Defense: YES or NO (circle one) Entered into website on:______________ By: ______________

Acceptance of Thesis/Dissertation Revised 01/2016 Page 1 of 1

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