UNIVERSITY OF BERGEN

APPLICATION FOR SUBMISSION OF DOCTORAL THESIS

AND PROPOSED EVALUATION COMMITTEE

Please send the form and attachments to post@psyfa.uib.no.

The e-mail must clearly state which department the thesis is being submitted to.

Department
Doctoral candidate (name)
Personal id.no (11 digits)
Private address/phone
Workplace address/phone
E-mail
Educational background (degree)/year/institution
Name of main supervisor, title, e-mail, affiliation
Name of co-supervisor, title, e-mail, affiliation
Name of co-supervisor, title, e-mail, affiliation

PART I: THESIS

Thesis title:

The thesis is to be evaluated for (degree):	PhD	Dr.Philos.

Is the thesis being submitted for evaluation for the first or second time?

Training component approved (date)
Date of Ouriginal check

Is the thesis a co-operation between other departments or institutions? If yes, name the involved partners.
Preferred language of the Diploma (check one box)	Norwegian (bokmål)	Norwegian (nynorsk)	English

The applicant hereby confirms that the stated information is correct, and the thesis has not been submitted for evaluation at another institution.
Date:	Signature of applicant:

The following documents must be submitted with this form:

The thesis, in one single pdf-file (an article-based thesis must include both the summary “kappen” and the articles in the same file)

Declaration describing the independent research contribution of the candidate (please use declaration form)

Declarations of impartiality of suggested evaluation committee members (please use declaration form)

Documentation of necessary permits/approvals regarding ethical clarifications etc. (unless included in the thesis itself)

DEL II: PROPOSED EVALUATION COMMITTEE

The department proposes that the following members are appointed as evaluation committee:

1. Opponent:	2. Opponent:	3. member/ committee leader:
Name and work affiliation:	Name and work affiliation:	Name and work affiliation:
Academic degree:	Academic degree:	Academic degree:
Work title:	Work title:	Work title:
Phone:	Phone:	Phone:
E-mail:	E-mail:	E-mail:

The proposed committee members have agreed to be part of the evaluation committee.

Impartiality: An evaluation committee must be impartial, as stated in the “Public Administration Act §§ 6-10”. In addition, members of the committee cannot, as a rule, have had any research collaboration (i.e. publications) with the doctoral candidate or supervisor during the last three years. If there is reasonable doubt about the impartiality of any committee members this should be addressed specifically in the declaration of impartiality form.

Date:	Signature main supervisor:

The head of department hereby confirms that the proposed evaluation committee has been deemed impartial in their relationship to the doctoral candidate and her/his supervisor(s).
Date:	Signature head of department:

ADDITIONAL INFORMATION

Regulations for the doctoral degree philosophiae doctor (PhD), UiB:

Section 11-2. Appointment of the assessment committee

When the faculty itself has approved the application for thesis assessment, the faculty itself shall appoint an expert assessment committee of at least three (3) members which shall evaluate the thesis. The rules on impartiality contained in section 6 of the Public Administration Act apply to the members of the committee.

The basic academic department shall propose the composition of the assessment committee. The candidate will be notified of the proposal for the composition of the committee, and they may submit written comments no later than five (5) days after the basic academic unit has sent the proposal to the faculty. The faculty itself decides whether such comments shall be taken into account.

Normally the committee should be appointed no more than four (4) weeks after approval of the candidate's application for thesis assessment.

The composition of the assessment committee is normally to be such that:

-	both genders are represented

-	the majority have no association with the University of Bergen

-	one of the members, if possible, is from a relevant foreign institution

-	all the members hold doctoral degrees or equivalent qualifications.

Specific reasons must be supplied if these criteria are not complied with. The appointed supervisor may not be a member of the committee. The faculty appoints one of its representatives as chair of the committee.