Nomination for the Appointment of Examiners

Nomination for the Appointment of Examiners

This form is to be completed by the Principal Supervisor of the candidate at least 3 months prior to submission of the thesis and submitted to the Faculty Office. Please note that the form will not be considered by the Faculty unless all relevant sections have been completed. In completing this form, supervisors are asked to review Section 19 of the Research Higher Degree Policies and Procedures relating to the appointment of examiners (available at:flinders.edu.au/ppmanual/student/research-higher-degrees.cfm). In particular, please refer to clauses 19.2, 19.3 and 19.4.

[Faculty of Medicine, Nursing and Health Sciences only] At least one nominee must be located overseas. The Faculty observes the convention of not appointing examiners from the city in which the candidate is based.

Once the form has been signed by the supervisor and Dean of School (or nominee) please email this form (and attachments) to .

A.CANDIDATURE DETAILS

Name: Student ID:

Degree:

Flindersemail address for correspondence: FAN: ______

Date or expected date of completion of thesis: ____/____/______

Department/School: ______

Name of Principal Supervisor:

Name of Associate Supervisor(s):

Name of Adjunct Supervisor(s):

B.THESIS DETAILS

Thesis Title:

______

Thesis Type (delete as appropriate): standard / creative component / Cotutelle agreement / written in a language other than English (refer to 20.920.10 of RHD Policies and Procedures) / PhD by Published Work (refer to Course Rule).

1.As outlined in Appendix F, clause 4 the candidate has the opportunity touse electronic text-matching software to assist with the monitoring of academic integrity. Has the candidate used text-matching software? YES/NO

Faculty of Medicine, Nursing and Health Sciences candidates only are required to use electronic text-matching software.

2.Is the candidate’s research project subject to an Intellectual Property/Confidentiality Agreement?YES/NO

If yes please provide further information on examination process requirements (eg is a confidential disclosure agreement required).

______

3.Doctoral CandidatesOnly: A citation of no more than 150 words (and 2-3 short sentences) is attached and has been emailed to: YES/NO (delete as appropriate)

The electronic citation form can be located at: flinders.edu.au/current-students/graduation-beyond/graduation/graduate-information.cfm (in the box on the right-hand side for Doctoral Graduands).Please note: Candidates enrolled in the Faculty of Science and Engineering do not have to complete this form as this task is carried out by the Principal Supervisor.

The citation will be included in the graduation booklet when candidates are awarded their degree, including absentia graduates. The thesis title will be read out at the Graduation Ceremony along with 2-3 short sentences about your thesis provided by you.For both, please identify the key contributions and significance of the research that is in a style easily understood by graduands, their families and guests.
Please note: The citation text is also used for the Australian Higher Education Graduation Statement (AHEGS) provided to each graduate. For more information about the AHEGS go to: flinders.edu.au/enrolling/student-records/ahegs.cfm

[Faculty of Medicine, Nursing and Health Sciences only]

4.The Faculty of Medicine, Nursing and Health Sciences requires that each candidate present a final report and seminar prior to the submission of his or her thesis.

Has the Final Report been completed? YES/NO (delete as appropriate). If not, when will the final report be submitted to the Faculty Office? Please ensure that it is submitted prior to the candidate’s thesis submission.

C.EXAMINERS

Examiner 1:

Title: Name:

Address 1 (physical for courier):

Address 2 (postal):

Telephone: Email:

Qualifications and Research interests relevant to the thesis:

Attach to this form bibliographical and publications (for last 5 years in chronological order) details of Examiner 1. Bibliography must include current position, or any information relevant to selection as an examiner. Please highlight on thefull list of publication details the 5 most recent relevant publications.

Have you already approached this potential Examiner in relation to examining the thesis? YES/NO

Please attach a copy of the correspondence includingthe potential examiners acceptance.

Examiner 2:

Title: Name:

Address 1 (physical for courier):

Address 2 (postal):

Telephone: Email:

Qualifications and Research interests relevant to the thesis:

Attach to this form bibliographical and publications (for last 5 years in chronological order) details of Examiner 2. Bibliography must include current position, or any information relevant to selection as an examiner. Please highlight on the full list of publication details the 5 most recent relevant publications.

Have you already approached this potential Examiner in relation to examining the thesis? YES/NO

Please attach a copy of the correspondence includingthe potential examiners acceptance.

D.RESERVEEXAMINERS

Reserve Examiner 1:

Title: Name:

Address 1 (physical for courier):

Address 2 (postal):

Telephone: Email:

Qualifications and Research interests relevant to the thesis:

Attach to this form bibliographical and publications (for last 5 years in chronological order) details of Reserve Examiner 1. Bibliography must include current position, or any information relevant to selection as an examiner. Please highlight on the full list of publication details the 5 most recent relevant publications

Have you already approached this potential Examiner in relation to examining the thesis? YES/NO

Please attach a copy of the correspondence includingthe potential examiners acceptance.

Optional Reserve Examiner 2:

Title: Name:

Address 1 (physical for courier):

Address 2 (postal):

Telephone: Email:

Qualifications and Research interests relevant to the thesis:

Have you already approached this potential Examiner in relation to examining the thesis? YES/NO

Please attach a copy of the correspondence includingthe potential examiners acceptance.

E.CONSULTATION WITHCANDIDATE

Have you as supervisor consulted the candidate on objections theymay have to any potential Examiners?YES/NO

(Refer Clause 19.2 (viii)Research Higher Degrees Policies and Procedures)

If there were any objections, please provide details:

______

Attach a list of publications from the candidate generated during the current candidature.

F.AFFILIATIONS AND CONFLICTS OF INTEREST

Do you have any external affiliations with other higher education institutions, such as Academic and/or Adjunct status? Yes No

Please declare them here with details:

______

Examiners must be independent of Flinders University(Refer Clause 19.2 (vi)RHD Policies and Procedures Manual). Are thereany potential or perceived conflicts of interest as detailed below?Yes No

Selecting any of the boxes in these sections, may not necessarily preclude a nominee from examining thethesis; however, all potential conflicts should be declared so that an assessment can be made
I, or the candidate, have published with one or more of the nominees in the last 5 years.

I hold a current grant or have applied for a grant with one or more of the nominees.

 I have or have had a close personal, professional or commercial relationship with one or more of the nominees.

 One or more nominees are, or have been, an employee (incl. Adjunct & Honorary) or graduate of Flinders University in the past five years.

Other, provide details:

______

G.RECOMMENDATION BY PRINCIPAL SUPERVISOR AND DEAN OF SCHOOL (OR NOMINEE)

Please confirm that a 500 word summary of the candidate’s thesis is attached:

Please confirm that you have reviewed the citation and short sentences for the candidate’s thesis:

We nominate and recommend the appointment of the proposed examiners listed in Sections C and D above:

Signature: (Principal Supervisor)Date: ____/____/______

Name: ______(Dean of School or nominee)

Signature: Date: ____/____/______

H.FACULTY DETERMINATION

The Faculty approves/does not approve the above nominations

Name:(Chair, FacultyRHD Committee)

Signature: Date: ____/____/______

Please email this form (and attachments) to once the form has been signed by all parties.

FACULTY USE ONLY

Date: ____/____/_____ Received by RHD Administrative OfficerName:

Date: ____/____/_____ Examinersrecorded on Student TwoDate: ____/____/_____ Examiners invited

KJ:JBJune 2015