Application for Dissertation Proposal
Note: In order to advance to Level III, students must submit an Application for Dissertation Proposal via this page, and a completed Program of Study Worksheet (to be e-mailed to your faculty advisor who must submit the signed & dated form to the Office of the Registrar). For Program of Study Worksheets, see: https://sph.cuny.edu/academics/forms/

Applications for dissertation proposal are approved by Department Chairs. Program of Study Worksheets are approved by the Registrar's Office.
Student Last Name: *
Student First Name: *
Student EMPL ID: *
Student E-mail Address: *
Student Concentration: *
Dissertation Proposal Title: *
Name of dissertation committee chair : *
Name of dissertation committee member #1: *
Name, affiliation, and e-mail of dissertation committee member #2 (outside CUNY SPH): *
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