GRADUATE STUDENT
I
NDEPENDENT STUDY FORM
Attached is a request for independent study at the graduate level. Please be aware of the
following information:
Purpose of independent study: To allow students to engage in research and/or
study in a specialty area that is not available through established course
offerings.
Only matriculated students with 3.0 GPA or higher may register for an independent study
and should be toward the end of their degree work.
Students are limited to one independent study.
Independent studies may not be taken in addition to a full-time (12 credit hour) schedule.
Independent studies are directed by full-time Nazareth faculty sponsors.
These studies are independently directed and therefore meeting times and dates must be
firmly established with your professor before approval will be granted.
Procedure for Independent Study: Independent studies require a great deal of time and
effort. The approval process may take up to one month to complete. The independent
study proposal, with all signatures, must be completed two weeks prior to the beginning
of the semester in which the independent study is to be taken.
1. Meet with your program advisor to discuss the possibility of proceeding with the
request for independent study.
2. Meet with the following people to discuss your project and obtain approval signature
on the attached form “
Student Proposal for Graduate Independent Study
”:
a. Program Director
b. Faculty Sponsor
c. Department Chairperson(s)
3. Submit to the appropriate person in Section B of the attached form “
Student Proposal
for Graduate Independent Study
”:
a. A completed proposal form. You must use the attached format in designing
your independent study proposal.
b. All required signatures in Section A of the attached form “
Student Proposal for
Graduate Independent Study
”.
c. Additional copies two additional copies of your proposal (excluding the
signature cover sheet).
4. Upon approval, a course number will be assigned and you will be registered in the
independent study.
5. PLEASE NOTE: Once you have completed your study, two copies of your project
must be submitted to your faculty sponsor.
4245 East Avenue Rochester, NY 14618-3790 Phone 585.389.2819 Fax 585.389.2612
STUDENT INFORMATION
Name ___________________________________ ID or SSN __________________________
Email_____________________________________ Phone_____________________________
___________________________________ _______________________________
Student Signature Date
INDEPENDENT STUDY INFORMATION
Term Fall Spring Summer A Summer B Year: ___________ Credits: _________
Title: _____________________________________________________________________________
Attach an independent study proposal with the following required information:
1. Description of Suggested Project
2. General Objectives
3. Specific Objectives
4. Objective #1 Activities/Approaches/References
5. Objective #2 Activities/Approaches/References
6. List of confirmed meetings dates with faculty sponsor and criteria for project evaluation. Note:
Evaluation should be done in accord with the standards required for regular graduate courses. See
the Graduate Catalog for grading.
APPROVAL SIGNATURES SECTION A
___________________________________ ___________________________________
Program Advisor/Date Program Director/Date
___________________________________ ___________________________________
Faculty Sponsor/Date Faculty Sponsor’s Department Chair/Date
___________________________________
Student’s Department Chair/Date
APPROVAL SIGNATURE SECTION B
Once all of the above signatures in “section a” are obtained, submit the completed proposal to the
appropriate Dean
below.
_______________ _____________________________________
Dean, School of Health & Human Services (Dr. Brigid Noonan) Date
Dean, College of Arts and Sciences (Dr. Dianne Oliver)
Dean, School of Education (Dr. Kathleen Daboll-Lavoie)
Dean, School of Business & Leadership (Dr. Kenneth Rhee)
When completed, please submit this original form with supporting paperwork to the
Office of the Registrar, Smyth Hall Room 1.
Student Proposal for Graduate Independent Study