Grade Mode: (check one)
Semester Year Letter Grade
Pass or No Pass
Student's name (please print)
ID
Department Crse # # of Credits
Instructor (please print)
Title
Shortened Title
(your preference - 26 characters)
Required Signatures:
Student Date
Faculty Supervisor Date
Chair Date
Dean Date
Registrar's Office use only
CRN Date Initials
Independent Study Contract
Instructions for Completing Form Online
Click here to print. Then obtain signatures and send.