Name ___________________________________________________________ Area __________
Date submitted ________________________ e-mail ____________________________________
I am applying to take the Research Qualifying Examination and will present research described in the attached one-page abstract. I carried out this research at (please check one):
The research was supervised by (please give rank and affiliation if
not an EECS faculty member):
_______________________________________________________________________________
The following EECS faculty members would be appropriate members of my RQE Committee (do not include your past or present research supervisor):
1. ________________________________________________________________
2. ________________________________________________________________
3. ________________________________________________________________
My current research supervisor is ________________________________________
Proposed dates for oral presentation: Between _________ and __________
(Remember that your written report is due two weeks before the oral
presentation.)
Your signature _______________________________________________________
Graduate Counselor's signature __________________________________________
Submit this form together with a one-page abstract to the Graduate Office, 38-444.