Before turning this form in to the Registrar’s Office, please
make a copy for yourself and your supervisor. Thank you!
Student Number Name _________________________________________ Year in College: Soph___ Jr___ Sr___
Email Advisor_______________________________________
International Student: Yes No *For WRI, please see backside for requirements*
Independent Study (298)
Independent Research (398)
Faculty Supervisor
Course title to appear on transcript (32 characters maximum)
Complete all sections below (attach additional pages if needed):
IS/IR Supervisor Signature Date:
If WRI checked above, do you agree to conduct IS/IR as a WRI experience? YES NO_____
Department Chair/
Interdisciplinary Program Director Signature ____________________________________________Date:
Advisor Signature_______________________________________________________________________Date:_______________
Check one: _____on-campus _____off- campus ____Int’l off-campus
Int’l & Off-Campus Study Office Signature
(Signature only needed if doing International IS or IR)
Required information if doing off-campus or Int’l Independent Study/Independent Research:
Location Name ________________________________________Street address____________________________________
City, State/Country, Zip______________________________________________________ Phone #___________________
Major goals of this course and why it should be done independently (guidelines on back):
Previous Preparation for this course (list specific courses taken):
Core resources/bibliography:
Outline of specific work to be done in IS/IR and how work will be supervised (frequency of meetings, etc) and evaluate:
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Please note college policy for IS/IR:
On or before the deadline to add courses:
1. Submit the application to the Registrar’s Office in Tomson Hall. Make a copy for your own records. The Registrar’s
Office will add the course only after this form has been submitted and approved. After the last day to add a course, a
late add petition to add the course is required and, if approved you will be charged a handling fee of $50.
2. Please note: The student must have some prior course work or other background learning relevant to the proposed
independent project:
To attempt IS (298) at least two prerequisite courses are required.
To attempt IR (398) course, five prerequisite courses are required
First-year students may not take IS/IR courses.
3. IS/IR does not fulfill a General Education Requirement (unless approved for WRI). See department chair/program
director for information whether the IS/IR will apply towards your major.
GE Guidelines for Applying Writing (WRI) to Independent Study/Research
Students: You must also include a separate rationale that specifically addresses all of the intended learning outcomes for
WRI, taking into account the guidelines:
WRI will not be approved if you do not provide a rationale.
Faculty: When approving WRI for an independent study/research check the WRI approval line next to the faculty
supervisor signature line on the form.
Guidelines for Writing in Context courses:
1. The course helps students write effective prose in a particular community of knowledge.
2. The course incorporates writing as a principal and integral part of learning.
3. The course must provide instruction in writing and must require students to revise their work in response to
instructor feedback.
Explain how you will meet the following intended learning outcomes through your Independent Study/Research:
The student will demonstrate:
1. The ability to write effectively in a form appropriate to a particular disciplinary or interdisciplinary course of study.
2. The ability to write as a means for inquiry, learning, thinking, and communicating.
3. The ability to engage in writing as a systematic, iterative process, using flexible strategies for generating drafts,
responding to feedback, revising, editing, and proofreading.
I have read the requirements for Independent Study or Independent Research and understand and agree to
the conditions and guidelines outlined on this form and other conditions pertaining to this application as
stated in the catalog.
Graded _____S/U_____
Student’s Signature Date *Please choose a grading option after your supervisor has signed this form.
Registrar Date:
(Registrar’s signature added upon final approval. Submit form to Registrar’s Office after obtaining above signatures.)
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