Adult Development & Aging Doctoral Program
A Joint Program of
Cleveland State University & The University of Akron
Petition to Defer Dissertation Proposal Defense
Name
Procedure
In the event that a student is unable to defend his or her dissertation proposal by April 1 of the fourth
year, he or she must petition the faculty to request an extension. This completed form is due to the
Program Chair by March 1 of the fourth year.
Reason for Requesting Extension on Dissertation Proposal Defense Deadline
Please describe the reason for requesting an extension on this deadline in the space below.
Revised Date for Dissertation Proposal Defense
I will defend my dissertation proposal on
(Date)
Signatures
Student:
Print Name:
_________________________________________
Date: ______________
Advisor:
Print Name:
________________________________________
Date: ______________
UA Committee Member: ________________________________
Print Name:
Date: ______________
CSU Committee Member: _______________________________
Print Name:
Date: ______________
Outside Committee Member: ___________________________
Print Name:
Date: ______________
Committee Member____________________________________
Print Name:
Date: ______________
Program Chair: ________________________________________
Print Name:
Date: ______________