Enrollment in an Independent Study Course 4995-Undergraduate
Purpose: Used by Undergraduate students to request enrollment in a course whose mode of instruction offers the student an opportunity to study or research a topic or subject matter in-depth with a current
Marquette faculty of his/her choice that is usually not offered in the established curriculum and independent of the classroom setting.
@marquette.edu
Section 1: Student Information
Section 2: Independent Study Course Information
Subject. Code
(e.g. ENGL)
Specific Title. The course will not be recorded on the student's record unless a specific title is provided. Use a maximum of 60 characters.
Credit Hours
Year
Signature of Dept. Chair Date
Student Instructions:
1. Register via CheckMarq for all other courses you may also be taking. Do not wait until the Independent Study course is processed.
2. Complete Sections 1 & 2 of this form, using a computer.
a. a handwritten form will not be accepted.
b. an incomplete form will not be processed and will be returned to you for completion.
3. Print the form using the 'Print Form' button below.
4. Sign the form in Section 3; a digital signature is not acceptable.
5. Obtain all signatures as indicated in Section 4.
6. Submit this request to the college or dean's office of your home college. All colleges: the deadline to submit this request is the Thursday of the 1st week of Session 1 for fall and spring terms. The
deadline for summer term is the Thursday of the first week of Session 6.
7. Confirm your registration in this course via CheckMarq after allowing five days for processing.
Home College Office Instructions:
1. Approve request with signature in Section 5.
2. If needed, provide copies of this form to the student, instructor, department and the college or dean's office of the college offering the course.
3. After approval, scan the request to the Office of the Registrar via ImageNow. If this course causes a credit overload, the Credit Overload form must be sent with this request. The Office of the Registrar will register
the student for the course.
Note: Independent Study requests for traditional Undergraduate students will be scheduled in Session 1 for fall/spring and in Session 6 for summer; Professional Studies Programs enter session in Section 5.
Rev 5/2019
Signature of Dean/Designee of Student's Home College (if different from above) Date
Signature of Instructor
Date
Instructor Name
Instructor MUID
Term
Fall, Spring or Summer
Signature of Dean/Designee of College Offering the Course
Date
Grading Basis
Home College Degree Requirements: Major Minor Elective Session (Professional Studies Program only)
If major or minor, list specific requirement (e.g. British Literature)
Section 4: Instructor Information and Signatures
Signatures below verify this Independent Study will be conducted in accordance with the contact hour requirements of the University Scheduling policy and will be utilized as defined in the Purpose above.
Section 5: Home College Approval/Signature
Signatures below verify that this student will be monitored in accordance with the contact hour requirements of the University Scheduling policy and the Independent Study will be utilized
as defined in the Purpose above.
Section 3: Student Statement/Signature
I am aware of the number of hours per week that this Independent Study requires, and I affirm that I will work that number of hours. If I become unable to work the required number of hours, I will notify my department
to have my credits changed appropriately.
Signature of Student Date
MUID
Email
College
Address
Name
Last name, First name, Middle name
Rationale for this request
Number of credits in which you are currently enrolled
if this request will take you over the maximum credit load allowed for your college, you must also submit a Credit Overload request with this form.
H Course
