PhD Warrant Request Form PhD Warrant Request Form Legal Name First Last Name in Use (fill out only if you have designated a Name in Use (AKA Preferred Name) at profile.wisc.edu and would like it to be used on your warrant instead of your legal name) First Last Term during which your degree will be awarded (e.g., fall 2028)Date of Dissertation Defense MM slash DD slash YYYY Time of Dissertation Defense Hours : Minutes AM PM AM/PM Location of Dissertation DefenseDissertation Title (can change over time)Date you plan to deposit your dissertation MM slash DD slash YYYY Indicated any committee changes not reported previouslyList committee members designated as readers, or the committee members responsible for reviewing the content of your dissertation. Most students list all committee members as readers, but discuss with your committee first to confirm.List any graduate/professional certificates earned, if applicable.If applicable, list coursework approved for transfer from prior institutions.Which groups, if any, would you like your dissertation defense to be announced to? MET students only MET faculty only Both MET faculty and MET students Please provide a forwarding email address (not affiliated with UW-Madison)UntitledPhoneThis field is for validation purposes and should be left unchanged.