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
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
