STUDENT'S NAME: _____________________________________________________

Degree Sought (check one): __ M.S. __Ph.D.

Degree Program (check one): __Biology __Microbiology

Dr. ____________________________ has agreed to serve as major advisor for _______________________________ during the course of studies toward the Master's/ Ph.D. (cross one out) degree in Biology / Microbiology. (cross one out).

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(Signature of Major Advisor) (Date)

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(Signature of Graduate Student) (Date)

NOTE: When completed, submit to Becki Bohnenblust, Division of Biology, Ackert Hall, KSU

THESE ARRANGEMENTS SHOULD BE MADE AS SOON AS POSSIBLE, BUT NO LATER THAN THE END OF THE STUDENT'S FIRST SEMESTER.

Name and address of person(s) who suggested KSU Biology to you. We would like to write and thank him/her for doing so.