Center for Academic Success and Registrar ● PO Box 770 ● Georgetown, TX 78627
Phone: 512-863-1952 ● Fax: 512-863-1685 ● firstname.lastname@example.org
S:\Registrar\Forms\Independent Project Form FA18
INDEPENDENT PROJECT FORM
Please submit the following items to the Office of the Registrar. The course will not be added to your schedule until
all paperwork is received. All documentation must be submitted by the last day to add classes.
Independent Project Form
Syllabus (must include the percent value of the various elements that will be used in the final evaluation
of the course/project and the number of progress reports to be made by the student to the instructor)
Bibliography or list of resources to be used in the course
Signed add card
This form and the attached documentation will be retained for our permanent records. Regular Catalog courses may
not be offered as an Independent Study without prior approval of the Registrar.
Name: Semester: 20
Student ID or SS#: SU Email: @southwestern.edu
Phone: Classification: FY SO JR SR
Course Type: Independent Study Research Project Honors Project Tutorial
Title of Course/Project:
Department: Course Number:
Beginning Date: Ending Date:
The Beginning/Ending Dates are required and are the basis for enrollment, grading, and tuition. Please be realistic in dates for
the course. If we do not have a grade posted by the Ending date listed on this sheet, your grade for the course will be an “F”.
Statement of Purpose of Course/Project:
This course will be offered for a grade or P/D/F. Please check one. (Be sure that you check your Degree Plan
and major and minor requirements for any stipulations on you registering for a grade versus P/D/F).
This course is intended to fulfill the Capstone Requirement for the major: Yes No
Printed Name of Instructor Signature of Instructor Date
Student’s Signature Academic Advisor’s Signature Date
Department Chair’s Signature Date