Fillable INDEPENDENT STUDY PROPOSAL FORM Please be advised that (Fairleigh Dickinson University)

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INDEPENDENT STUDY PROPOSAL FORM Please be advised that (Fairleigh Dickinson University)

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The INDEPENDENT STUDY PROPOSAL FORM Please be advised that (Fairleigh Dickinson University) form is 1 page long and contains:

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  • 3 check-boxes
  • 20 other fields

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INDEPENDENT STUDY
PROPOSAL FORM
Please be advised that undergraduate students must have completed at least 60 credits, and be in good academic standing to be eligible for
Independent Study course work. Additionally, only 12 credits of Independent Study course work are normally allowed toward degree
requirements.
Last Name:______________________ First Name:_________________________ Student ID:______________________
Program
Major:__________________________
Concentration:______________________
E-mail:_________________________
Home Phone: (____)_________________
Cell Phone: (___)_________________
Course applicable to: (Check one)
Major elective
Free elective
Other (specify)
(specify course)*
COURSE CODE:
No. of Credits:
Semester:
Mentor:
How often will student and mentor meet? __________________________________________________________________________________________________________
Please be advised that the grade deadline for Independent Study courses is the term’s final day of classes, unless noted otherwise here: ________________________________
DEALINE FOR INDEPENDENT STUDY REGISTRATION: End of fourth week of Summer/Fall/Winter Semester
Student’s signature: _________________________ Date: _________________________
APPROVAL SIGNATURES
Mentor’s signature:
Date:
FDUV Coordinator
Date:
FDUV Provost
Date:
Chairperson’s signature:
Date:
Dean’s (or designee’s) signature:
Date:
FDU-Vancouver 842 Cambie Street Vancouver BC V6B 2P6 Canada
FDU V-Independent Study Proposal Form – December 2015
TO BE COMPLETED BY RECORDS OFFICE Date:_________________
CGPR
CUM. CREDITS
INDEPENDENT
STUDY CREDITS
COMPLETED
CHECKED BY:
STATEMENT OF PROBLEM:
GOAL OF PROJECT:
DESIGN AND METHOD:
Office Use Only:
Payroll:
Date:
Director of Enrollment Services:
Date:
Scheduling:
Date:
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INDEPENDENT STUDY PROPOSAL FORM Please be advised that (Fairleigh Dickinson University)

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Completed 21 August 2020

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