Fillable REQUEST FOR DIRECTED STUDY COURSE (Florida Institute of Technology)

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REQUEST FOR DIRECTED STUDY COURSE (Florida Institute of Technology)

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DATE _________________________________
NAME _______________________________________________________________________________________________________ STUDENT ID NO. ________________________________
Last First Middle
SEMESTER _____________________________________________________________________MAJOR ________________________________________________________/ _____________
Name of program/Major code
I request that I be allowed to register for Directed Study in the course indicated below:
CRN PREFIX COURSE NO. SECTION COURSE TITLE CREDITS
___________  _________  ______________  _________   ____________________________________________________________________________________ ________________
Description of Course Content (may be catalog course description)
STUDENT SIGNATURE ___________________________________________________________________________________________________ DATE _________________________________
REQUEST FOR DIRECTED STUDY COURSE
This form must be completed before processing at the Registration Center.
COURSE INFORMATION
Florida Institute of Technology § Oce of the Registrar § 150 West University Boulevard, Melbourne, FL 32901-6975 § 321-674-8115 § Fax 321-674-7827
RGR-463-0220
APPROVED BY
Academic Advisor _____________________________________________________________________________________________________  Date ________________________________
Print name __________________________________________________________________________________
Instructor ____________________________________________________________________________________________________________  Date ________________________________
Print name __________________________________________________________________________________
Head of Unit Oering Course____________________________________________________________________________________________  Date ________________________________
Print name __________________________________________________________________________________
OFFICE USE ONLY
Processed by ___________________________________________________________________________________________________________  Date ________________________________
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REQUEST FOR DIRECTED STUDY COURSE (Florida Institute of Technology)

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Completed 29 January 2021

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