Request for and consent to appointment as supervisor form a I, the undersigned



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Datum27.09.2016
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TypeRequest

DECEMBER 2012 TU DELFT GS FORM A


REQUEST FOR AND CONSENT TO APPOINTMENT AS SUPERVISOR FORM A
I, the undersigned;

Full name PhD candidate:

Date of birth:

Signature and date:










E-mail address:

(Mobile) phone number:







Research subject:



request, in accordance with Article 5 of the Doctorate Regulations, that the below-mentioned person(s) be appointed as my (co)promotor(s):

I/we, the undersigned,

Titles, initials and full name:

Professor at the University of:

Signature and date:

Prof.







E-mail address:

(Mobile) phone number:







Titles, initials and full name:

Professor at the University of:

Signature and date:

Prof.







E-mail address:

(Mobile) phone number:







having come to a go decision in accordance with Article 2.4, accept the request to act as promotor for the above-mentioned PhD candidate, and propose the following person as copromotor:
(Please find the letter in accordance with Article 9.1 enclosed)
I, the undersigned,

Titles, initials and full name:

UHD  UD at faculty:

Signature and date:










E-mail address:

(Mobile) phone number:






accept the request to act as copromotor for the above-mentioned PhD candidate.


We, the aforementioned, declare that we undertake to observe the stipulations of the TU Delft Doctorate Regulations.


(To be filled out by the office of the beadle)



Volgnummer aanmelding:

Datum binnenkomst:

Paraaf aanmelding ProZa:

Datum behandeling in CvP:

Paraaf akkoord namens CvP:
















Please submit this form to the office of the Faculty Graduate School EEMCS, room 16.280





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