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Dissertation Advisor / MTA Declaration Form

Student Information

Student Name*
Date of Matriculation*
Degree*
I expect to receive a PhD in (Please select one)*
Select your MTA for the PhD work:*
I agree to fulfill the requirements of the proposed training area.*
Dissertation Advisor Name*

To be completed by the Dissertation Advisor

Dissertation Advisor*
I have read the Compact between Research Advisor and Student and understand its content.*

I understand that I will be responsible for the stipend, tuition and fees for the student during the PhD work, until the thesis is defended, with appeals possible for unexpected lapses in funds.

Department Administrator Name
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Department Approval

Name*
Use your mouse or finger to draw your signature above