Certificate of Approval Form for Undergraduate Theses and Professional Papers

This form serves as the official record of undergraduate thesis or professional paper submission to the Davidson Honors College atTheUniversity of Montana and is not included in the final electronic document.

The information provided below should INCLUDE THE SAME INFORMATION approved on the title page of your electronic document.

Complete this form electronically and print for signatures. NO HANDWRITTEN copies will be accepted.

Author’s Name
(Use full legal name) / Enter your name / Student ID: / Semester and Year of Graduation
Degree Type / Major & Option
(if applicable) / Document Type
Name of Department / College
Undergraduate Thesis or Professional Paper Title
Keywords or Phrases concerning subject of document
(separated by commas)
E-mail Address / Display Email Address on Title Page of Electronic Document? / YesNo

Student Agreement:

1.  I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted material to be included in my undergraduate thesis or professional paper, allowing distribution as specified below.

2.  I certify that the version I submitted is the same as the final copy approved by my faculty mentor.

3.  I hereby grant to UM and its agents the non-exclusive license to archive and make accessible my undergraduate thesis or professional paper in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the undergraduate thesis or professional paper. I also retain the right to use in future works (such as articles or books) all or part of the undergraduate thesis or professional paper.

Student and Faculty Mentor Agreement (select one of the following):

Release the entire work immediately for access worldwide.

Release the entire work for UM access only.

No access for a period of one year (this can be extended in one year increments by contacting the

Mansfield Library). This option addresses situations such as when a patent application is planned, or when proprietary interests are at stake. Start Date: End Date:

Release the entire work for UM access only, and selected portions worldwide. File names as follows (i.e., names of separate PDF or multimedia files for restricted UM access):

Review and Acceptance:

The aforementioned document has been reviewed and approved to meet the undergraduate thesis and professional paper requirement by the student’s faculty mentor and a second faculty reader. The undersigned agree to abide by the statements above, and confirm that this Approval Form serves as the Certificate of Approval for the undergraduate thesis or professional paper including the Abstract.

Student / Signature / Date
Faculty Mentor / Signature / Date
Second Faculty Reader / Signature / Date
James McKusick
Dean, Davidson Honors College / Signature / Date