KENT STATE UNIVERSITY

REPORT OF FINAL EXAMINATION

AFTER VERIFICATION OF THIS FORM BY THE COLLEGE OR INDEPENDENT SCHOOL, A COPY WILL BE RETURNED TO THE DEPARTMENT.

Student Number___________________ Date of Final Exam:__________________

1. Name of candidate ____________________________________________________________________

LAST FIRST MIDDLE

Address ____________________________________________________________________________

NUMBER & STREET CITY STATE ZIP

2. Degree for which examination is given____________________________________________________

3. Department__________________________________________________________________________

Special area of concentration (if any)______________________________________________________

4. Exact title of thesis or dissertation________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

5. If master’s degree candidate elected an option not requiring a thesis, indicate which one and briefly describe work done in lieu of thesis_______________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

6. Signature of examining committee:

Name (typed or printed) Signature Pass Fail*

(Use check mark)

_________________________ ____ ____

COMMITTEE CHAIR

_________________________ ____ ____

_________________________ ____ ____

_________________________ ____ ____

_________________________ ____ ____

_________________________ ____ ____

OUTSIDE DISCIPLINE PERSON

_________________________ ____ ____

GRADUATE FACULTY REPRESENTATIVE

FINAL RESULT: Pass ˜ Fail ˜

___________________________________________________________

MODERATOR (doctoral examination only – does not vote)

*Attach comments or specified conditions if student fails.

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CHAIR, DIRECTOR OR DEAN