External Examiner Nomination Form

Your Name

Your email

Student information

Student's name

Student identification number

(if known)

Tentative Defence Date

You may enter a confirmed date (not required), or an estimated date to indicate the earliest point that the defence may be planned for. Ideally, this is at least 3-4 months in the future.

Examining committee

Please enter full name of each member of the committee.

Supervisor

Co-supervisor

(if applicable)

Committee member

Internal/External Examiner

External Examiner

External Examiner email

Institution of External Examiner

External Examiner Criteria

Read each statement below and check each box indicating you have read, understand, and agree with the statement. You must select all in order to submit the form.

I confirm that the external examiner has not published nor are there plans to publish with the student in the foreseeable future.

I confirm that the external examiner has not co-authored any publication within the last 6 years, or is in the process of joint publishing with the student , the supervisor, or any member of the examining committee.

I confirm that the external examiner has not held research funding within the last 6 years, or is in the process of applying for research funding with the student, the supervisor, or any member of the examining committee.

I confirm that the external examiner has never had a business, commercial, or financial relationship (or expects to enter into such a relationship) with the student, the supervisor, or any member of the examining committee.

I confirm that the external examiner has never had a personal or professional relationship or has a familial relationship with the student, the supervisor, or any member of the examining committee.

I confirm that the external examiner has never been in a supervisor/student relationship with the supervisor, the student, or any member of the examining committee.

Has the proposed external examiner ever been a student or employee of the University of Waterloo?

Yes

Rationale for Recommendation and Disclosure of Potential Conflict of Interest

Please address any potential conflicts of interest and provide a brief justification in support of the nomination.

External Examiner CV

Attach the current and complete CV of the nominee that includes publications covering at least the past 6 years, and a full list of supervised graduate students. Please highlight 3–5 publications that are directly relevant to the student's thesis topic (or include a list in a separate document below).
One file only.
25 MB limit.
Allowed types: pdf, doc, docx.

Relevant Publications

If not highlighted in the submitted CV, attach a list of 3–5 publications (from within the last 6 years) that are directly relevant to the thesis topic.
One file only.
25 MB limit.
Allowed types: pdf, doc, docx.

Number of graduated PhD students

Please indicate the number of PhD students the external examiner has supervised to completion.

Number of current PhD students

Please indicate the number of current PhD students the External Examiner supervises.

Confirmation

I confirm that the information submitted in this form is complete and accurate to the best of my knowledge.

External Examiner Nomination Form

Affiliations