Individual Learning Agreement /
Independent Study Form
Independent Study/Directed Research Policies:
1. Students must be in good academic standing
2. Students must arrange the independent study with a full time Vanderbilt faculty member who has agreed to supervise and
grade this experience.
3. Registration for an independent study will not be allowed after the registration change period has ended.
4. Students may not repeat independent study courses for grade replacement.
5. The content of the independent study/directed research must not be the same as a regularly offered course. Study must
include substantial research or reading in an area not covered in the regular offerings of that department.
Course Title: (the project name for your independent/directed study – 45 characters max; this can
be whatever you and your supervisor agree upon, and it will appear on your transcript)
# of credit hours
(i.e. HOD, PSY-PC, etc)
(i.e. 3860, 7960, etc)
(i.e. Fall 2020)
Instructor: (Please PRINT first and last name. Instructor must be a full-time faculty member)
Describe the nature of your individualized learning experience (Be as specific as possible, including a brief
description of the project/placement, and any required readings and assignments):
Describe your specific responsibilities:
Student Information (PRINT CLEARLY; all fields required):
Full Name:___________________________________________________ Student ID # (e.g. 000162030) ______________________
Classification: Undergraduate: FR____ SO____ JR____ SR____
Professional: M.Ed.____ M.P.P.____ Ed.D.____ Non-degree____
Anticipated Date of Graduation: Aug___ Dec___ May___ (year) 20_____
Major/Program: _____________________________________ Major Track(s), if applicable:_____________________________