Supervisor & Examiner Contact Information Form

In order to process your honorarium, we require the following information:

Supervisor Information
Supervisor's Name:
Phone:
E-mail:
Social Insurance:
Student’s Name:
Are you an employee of MUN:   Yes No
Mailing Address: (Include postal code)
Suggested Examiner (determined by the supervisor) Please note: the supervisor cannot be the examiner of the final report.
Examiner’s Name:
Position/Title:
Highest Degree Earned:
Phone:
E-mail:
Mailing Address: (Include postal code)
By submitting this form, you are confirming that the examiner has been contacted and agrees to serve in this capacity. If you have any questions or concerns please contact us by E-mail or call 709.778.0522.