SEMESTER: ____ Summer ____ Fall ____ Spring YEAR: 20 __ __
Last Name First Name
Student ID Number
Preferred email address
Independent Studies (295, 495) in
Number of units completed in Independent Studies offering in this department
Number of units enrolled this semester in Independent Studies offerings
Number of units in Independent Studies offerings completed at SCC
Approval:
Supervising Instructor Name - printed
Middle Initial
Class Number
Units Anticipated
(3 units maximum in one department)
(6 units maximum in one semester)
(9 units maximum allowed toward graduation)
Date:
Supervising Instructor's Signature
Date:
Division Dean's Signature
Attach the course outline (description of work to be completed) for this Independent Studies offering.
In developing the course outline, please remember that these units are credited as "lab" units. Each unit represents approximately 54 hours of student time in this
independent study.
Application for Independent Studies must be filed before the end of the eighth week of the semester (fall and spring) in which the study is to be completed.
This document, along with the course outline, should be routed from the Instructor of Record to the Dean. If the Dean approves the Independent Study, then the Dean's
Office will create a change form for the course and send a copy of this form with the change form to the Instruction Office. Once the change form is processed, this form
will be forwarded to the Admissions and Records Office, where the student will be added. Once added, the student will be notified that they must pay course fees within 24
hours.
