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Independent Study Contract & Proposal
PERSONAL INFORMATION
First Name:
Last Name:
Middle Initial:
Email Address:
PROPOSAL INFORMATION
What is the title of your proposed Independent Study?
How many credits are you applying for with this proposal?
What is the precise subject matter and topic of your proposed Independent Study?
Why is an Independent Study course needed to study this material and cover this topic?
How do you plan to earn your unit(s) of credit for this Independent Study? (Check all that apply)
Producing a paper Total pages of written work Attendance of Seminars and Conferences Number of hours accrued Reading Total pages read in books, articles, etc. Listening/Viewing Total hours accrued listening to cassettes, watching videos etc.
You have 90 days from the time the course contract is signed to complete all required work for credit.
On what date do you plan to report the accrued hours for attendance, reading, listening etc. (as selected above) as well as turn in your written paper?
Who will serve as an Advisor for your Independent Study project?
Have you contacted this person and have they agreed to serve in this capacity?
Yes
No
STUDENT AFFIRMATION
Read the following text and then check the box below to indicate your agreement.
I have read and agree to the Student Affirmation listed above. Submission of this form constitutes my signature.
General Information