Fillable Request for Directed Study (Athens State University)

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Request for Directed Study (Athens State University)

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Request for Directed Study
THE STUDENT MAY NOT COMPLETE OR EARN MORE THAN 6 HRS OF CREDIT THROUGH
DIRECTED STUDY AT ATHENS STATE UNIVERSITY.
**Course syllabus must be included in request for Directed Study. You may attach an
electronic document for review.
Date:____________________________________
Semester:________________________________ College:______________________________
Student’s Name:__________________________________________________________________
Student ID Number:_____________________________________________________
Course Number:__________________ Course Title:_____________________________________
Credit Hours:_____________________ Instructor:_______________________________________
_________________________________ ______________________
Instructor Date
_________________________________ ______________________
College Dean Date
_________________________________ ______________________
Provost and Vice President Date
for Academic Affairs
To be assigned by the Registrar:
_________________________________ ______________________
Registrar Date
CRN Number_________________________________
Reviewed and approved by Curriculum Committee 1-8-13
Approved by Provost 1- 28-13
Request for Directed Study
Justifi cation for Directed Study
Reason for request: ________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Nature of the research proposal: _____________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Method used to evaluate research: ___________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Projected research completion date: __________________________________________
Signatures Required:
_______________________________ _______________________________
Student Date Professor Date
Reviewed and approved by Curriculum Committee 1-8-13
Approved by Provost 1- 28-13
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Request for Directed Study (Athens State University)

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Completed 28 January 2021

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