SJC DIS5 & DIS6 - Doctoral Defense Ballots

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St. John's College - Doctoral Defense Ballot & Report to the Dean - Forms DIS5 & DIS6

Please submit this form once you have successfully defended your dissertation and are ready to report the results to the Dean's office.

First and Last Name*

First Name

Last Name

X-Number*

St. John's University Email*

Confirm St. John's University Email *

Date*

Dissertation Title:*

Academic Program*

(e.g., Clinical Psychology, PhD)

What is your Department Chair's Email? (Please select one from the list below)*

Department/Institute/Division	Chair	Email Address
Biology	Dr. Howarth	howarthd@stjohns.edu
English	Dr. Travis	travisj@stjohns.edu
History	Dr. Rumstomji	rustomjn@stjohns.edu
Psychology	Dr. Hodges	hodgese@stjohns.edu

Defense Date

Mentor and Reader Information

Faculty Mentor Name*

Mentor's SJU Email*

Please re-enter mentor's SJU email *

Dissertation Reader 1 Name*

Dissertation Reader 1's SJU Email*

Please re-enter first reader's SJU email *

Dissertation Reader 2 Name*

If your second reader is an outside reader, please use this name: Outside Reader

Dissertation Reader 2's SJU Email*

Please re-enter second reader's SJU email *

If your second reader is an outside reader, please use this email address: hyslopa@stjohns.edu

Do you have additional St. John's faculty readers on your thesis committee?*

Yes No

How many additional readers from St. John's do you have?*

1 2

Additional St. John's Readers

Dissertation Reader 3 Name*

Dissertation Reader 3's Email*

Please re-enter third reader's SJU email *

Dissertation Reader 4 Name*

Dissertation Reader 4's Email*

Please re-enter fourth reader's SJU email *

Outside Readers

Are any of your readers from outside of St. John's University?*

Yes No

Outside Reader's Name*

Outside Reader's Email Address*

First Reader Approval

As the first reader of the student's dissertation committee, please indicate whether the candidate has passed the oral defense and if their dissertation is approved as presented.*

Passed and approved Passed and approved with revisions Did not pass