Fillable NEW MEXICO TECH Directed Study (New Mexico Institute of Mining & Technology)

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NEW MEXICO TECH Directed Study (New Mexico Institute of Mining & Technology)

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NEW MEXICO TECH – Directed Study
A Directed Study form is used to create a special course for a student. This is NOT a co-op form.
Directed Study course numbers are 491 for undergraduate level and 581 for graduate level.
Do not use this form if the course is already listed on Banweb.
Name_ ___ ID# __ Semester 20___
(Last) (First)
____________ _________________________________ _________ _________
CRN –done by registrar Subject & Course Number (491 or 581) Sem. Hrs. Semester
The special title for this course is (30 characters or less)
________________________________________
__________________________________________________________________________________________
Instructor Name_____________________________
(Please Print)
I will serve as Instructor for this course____________________________ _____________________
(Instructor’s Signature) (Date)
Advisor__
__________________________________________ ________________________
(Date)
Major Chair_________________________________________ ________________________
(Date)
Dept. Chair_________________________________________ ________________________
(Date)
Student Signature____________________________________ ________________________
(Date)
International Office___________________________________ ________________________
(International Students only) (Date)
It is the student’s responsibility to contact the instructor within the first three weeks of the semester to arrange topic &
reporting system requirements. If needing a co-op please see Student Affairs. REVISED 01/2014
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Completed 24 August 2020

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