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Leave of Absence Request
Proprietary Research Agreement
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Statement of Work Completion
Thesis Defense Request
Withdrawal Request
OFFICE OF GRADUATE STUDIES
Proprietary Research Agreement
  • In order to receive approval for a leave of absence, it is necessary that you complete the entire form and obtain the three/four required signatures BEFORE submitting this form to the Graduate Office.

  • Additionally, you MUST attach a plan (including a timeline and deadlines) for resuming and completing the work toward the degree in a timely fashion with this request or it will be denied.
Student Name:   CWID:
Degree:

Date:
Degree Title:  
  *Click here for degree title options
Thesis Title:

Request is made to store the graduation thesis or dissertation containing proprietary research for the above student for the following period of time (maximum twelve months):

through

It is understood and agreed that once binding and microfilming of the thesis is accomplished, copies held by the Colorado School of Mines will be stored in a vault in the Arthur Lakes Library for the period of time specified above. The author is responsible for personal and departmental copies of the thesis or dissertation.

 

_____________________________
Principal Investigator

_____________________________
Student

_____________________________
Dean of Graduate Studies

Note: A copy of the signed Proprietary Research Agreement MUST be submitted with the six or seven copies of the thesis when deposited with the CSM Library for binding.