I Understand and Agree That If My Dissertation Or Thesis Contains Copyrighted Materials
A graduate student must apply for admission to candidacy upon completion of 12 semester hours of graduate courses. This application should be completed with signatures (chairman, members, and graduate coordinator or department head) affixed and returned to the Graduate School Office. Please note that applicants who are writing a master’s thesis are required to sign the copyright compliance form (see back side of this form). Notification of the status of this application will be forwarded to the applicant shortly thereafter.
Name / Major
Address / Degree: / MA / MARCH / MBA
MED / MM / MS
Thesis / Non-Thesis / Anticipated date of completion
Thesis Title (if applicable)
If a student has not yet determined whether he/she will present a thesis, the title may be omitted, and the committee need not be appointed at this time. It will be the student's responsibility, however, to inform the Graduate School inwriting as soon as the topic has been approved and to have the chairman and each member of the committee sign the letter.
List all graduate courses completed:
Course # / Grade / Credit / Course # / Grade / Credit
(All graduate work pursued at UL Lafayette must be shown; however, indicate by asterisk courses which will not apply toward the degree.)
Graduate credits earned at UL Lafayette / GPA
Transfer credits officially approved: / Institution / Course # / Grade / Credit
GRE: / Test Date: / Verb. / Quant. / Anal. / Total
GMAT: / Test Date: / Total
CLID / Date / Signature
**************************************************************************************************************************
Is the above student's proficiency in English satisfactory? / Yes / No
A student enrolled in a program which does not require a comprehensive examination has no committee. The department head or graduate coordinator's signature suffices.
COMMITTEE'S APPROVAL:
Chair
Member Member Member
Graduate Coordinator or Department Head / Date
Graduate Dean’s Approval / Date
Graduate Council's Approval / Date
September 12, 2013
Distribution: Student, Chairman, Graduate Coordinator
Acknowledgment of Responsibility for Copyright Compliance
As a graduate student writing a thesis or dissertation at the University of Louisiana at Lafayette, I declare that I understand the contents of the following statements and that I intend to uphold the agreements therein.
- I understand and agree that if my dissertation or thesis contains copyrighted materials, either implied or indicated, I am solely responsible for obtaining written permission, where necessary, for same prior to the completion of any work as submitted for final review prior to its approval. It is my responsibility to maintain these written permissions.
- I agree to indemnify and hold harmless, the University of Louisiana at Lafayette, its employees, agents and representatives, in any claim or lawsuit that may be made or filed, which arises from my fulfillment of the requirements for my graduate degree, either thesis or dissertation, or similar work.
Name:
(Please print)
Signature:
CLID:
Date: