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CSBS Committee Matching Request Form
Congratulations!
You have reached a significant milestone in your doctoral journey. It is time to request that your doctoral capstone committee be matched to your projected study. This is an important step in the process; delay in submission or incomplete forms may delay future registration and progress.
Your program leadership will use information provided via this form to review your plans and needs to match you with an appropriate committee chair and second committee member. You may choose to request specific faculty members to serve on your committee. Requested faculty must be from within your program.
Please note that, while we would like to honor all requests, the program leadership must take a number of factors into consideration. Faculty availability, expertise, and eligibility are among the considerations used for matching your content and methods plan to a committee chair and member.
Instructions
• Complete Part A: Student Information (Note: You will attach a copy of your most recent premise or prospectus in this section)
• Complete Part B: Faculty Information (Note: If you have identified specific faculty members you would like to request serve on your committee, you will need to attach a confirmation e-mail from each faculty member in this section.
• Submit Form
• PhD Students Only: Upload Confirmation E-mail (received upon successful submission) to the Assignment area of the Classroom to demonstrate completion of this assignment.
This confirmation e-mail will contain information about timelines and next steps in this process. Please review it carefully.
Today's Date
*
MM
/
DD
/
YYYY
Enter today's date. You can click on the calendar icon, on the right hand side of this field, to easily select the date.
Part A: Student Information
Student ID
*
Your student ID generally begins with "A00". If you need help, you can find your student ID on the upper-right corner of your student portal or on your degree audit.
Student Name
*
First
Last
List your name as it is listed in your Walden student record.
Student Walden Email Address
*
School
*
Please select
Barbara Solomon School of Social Work
School of Counseling and Human Services
School of Psychology
School of Public Policy and Administration
Program
*
Please select
DPA
PhD Criminal Justice
PhD Human Services
Phd HLTH Psyc
PhD I/O Psyc
PhD Public Policy and Administration
PhD Counselor Education and Supervision
PhD General Psyc
PhD Clinical Psyc
PhD Educational Psyc
PhD Social Work
PhD Forensic Psyc
PhD Social Psyc
PhD Counseling Psyc
PsyD Behavioral Health Leadership
Other
Other: Please specify your program.
What is the purpose of this request?
*
Please select
I am currently in PSYC 8702/FPSY8700 and wish to be enrolled in PSYC 8115/8185.
I am a Clinical Psychology student.
I am currently in PBHL 8900 and wish to enroll in PBHL 9001.
I am requesting processing for PSYC 9000 Dissertation.
I am requesting processing a second committee member. I already have an assigned committee chair.
Title of Prospectus/Premise
*
Are you a Fast Track Student?
*
Yes
No
If so, you must attach an email from your current dissertation faculty indicating you are ready to move.
Attach letter from current Dissertation Faculty
*
Enter the Quarter and Year that you want the committee assignment to start
*
For example: Fall 2018
Attach Prospectus or Premise
*
I am requesting assistance from CSBS in finding a Chair?
*
Yes
No, I have identified the following member to serve as my chair.
No, I already have an assigned chair.
Current Assigned Chair
First
Last
Selected Chair Information
ID #
Chair Name
*
First
Last
Faculty Walden Email Address
*
School
*
Please select
Barbara Solomon School of Social Work and Human Services
School of Psychology
School of Public Policy Admin
Program
*
Please select
Other
PhD Clinical Psyc
PhD Counseling Psyc
PhD Counselor Education
PhD Criminal Justice
PhD Educational Psyc
PhD Forensic Psyc
PhD General Psyc
Phd HLTH Psyc
PhD Human Services
PhD I/O Psychology
PhD Public Policy
PhD Social Psyc
PhD Social Work
Other: Please specify
Content or Methodology
*
Content
Methodology
Select only one option
Type of Methodology
Attach email from Chair confirming assignment
*
I am requesting assistance from CSBS in finding a committee member?
*
Yes
No, I have identified the following member to serve as my second committee member.
No, I already have an assigned committee member.
Current Assigned Second Member
First
Last
Selected Committee Member Information
ID #
Committee Member Name
*
First
Last
Committee Member Walden Email Address
*
Committee Member School
*
Please select
Barbara Solomon School of Social Work and Human Services
School of Psychology
School of Public Policy Admin
Committee Member Program
*
Please select
Other
PhD Clinical Psyc
PhD Counseling Psyc
PhD Counselor Education
PhD Criminal Justice
PhD Educational Psyc
PhD Forensic Psyc
PhD General Psyc
Phd HLTH Psyc
PhD Human Services
PhD I/O Psychology
PhD Public Policy
PhD Social Psyc
PhD Social Work
Committee Member Other: Please specify
Committee Member Content or Methodology
*
Content
Methodology
Select only one option
Committee Member Type of Methodology
Attach email from Committee Member confirming assignment
*