EAST ASIAN STUDIES

Preliminary Examination Committee

Name:	________________________________________	Date: ________
Local Address:	______________________________________________________ ______________________________________________________         ______________________________________________________
Local Phone Number:	_________________________

Committee Members:
______________________________________ (Print Name)	________________ (Field)	______________________________________ (Signature)
______________________________________ (Print Name)	________________ (Field)	______________________________________ (Signature)
______________________________________ (Print Name)	________________ (Field)	______________________________________ (Signature)
______________________________________ (Print Name)	________________ (Field)	______________________________________ (Signature)
______________________________________ (Print Name)	________________ (Field)	______________________________________ (Signature)

9/30/99