Student Name: ________________________________ Student ID Number: _______________________
Year in College: Soph Jr Sr
Will you be residing outside the U.S. while completing this course? Yes No
If “Yes,” list country: ___________________________________________ See item #6 on back of form
Major(s): _____________________________________________________________________________
Advisor: ______________________________________________________________________________
Minor or Certificate: ____________________________________________________________________
(if IS/IR is being applied to the minor or certificate)
DEPARTMENT: _________________ 495
# of Credits: ___________________
Semester: _____________________
Year: _________________________
Study Title: ___________________________________________________________________________
Major goals of this course: ______________________________________________________________
Complete all sections below (attach additional pages if needed):
Schoology access for another course required? No _____ Yes _____
CRN of course needed: ____________________________
Obtain the required signatures in the order listed below. STUDENT SIGNATURE IS REQUIRED ON THE
IS/IR Supervisor printed): _______________________________________________________________
Signature: ___________________________________________________________________________
Date: ___________________________
Department Chair/Interdis. Program Director:______________________________________________
Date: _________________________________
Registrar’s Office: __________________________________________ Date Added: _______________
CRN: ___________________________________
(over for directions and signature)
click to sign
click to edit
In order to be registered for this Independent Study/Research you must obtain all required signatures
and turn this form in to the Registrar’s Office. This form is due no later than the official last day to add a
class for the semester you are taking the IS/IR.
On or before the deadline to add full-semester courses:
1. Complete all spaces on the front side of this application--leave no blanks. Be sure to enter the
proper department and level for the IS/IR. An independent study/research course may carry 1-4 credits*
depending on department limitation and is registered for the full term. All IS/IR courses are letter
2. When the signatures of the instructor and the department chair/program director have been
obtained, submit the application to the Registrar’s Office. Make a copy for your own records before
turning in this form. The Registrar’s Office will add the course only after this form has been submitted
and approved. If you are not registered by the end of the full-semester add period, you will need to
petition to add the course and, if approved, will be charged a late fee of up to $75.
3. Please note: The student must have some prior course work or other background learning
relevant to the proposed independent project. First-year students may not take IS/IR courses.
4. IS/IR cannot fulfill a General Education Requirement. See department chair/program
director/advisor for information about how the IS/IR will apply towards a major, minor or certificate.
5. The academic expectation is that for each credit of IS/IR registered the student will spend 3-4
hours per week engaging the material (reading, writing, researching, lab time, consulting with instructor,
etc.), resulting in approximately 45-60 hours of work for a 4 credit course.
6. IS/IR to be carried out in a term the student is overseas requires the student to complete the
GoGlobal process with the GEL Office in order to register.
* An Academic Petition is required to request a B-Quad only IS/IR (1-2 credits only).
I have read the requirements for Independent Study or Independent Research and understand and
agree to the conditions and guidelines outlined on this form and other conditions pertaining to this
application as stated in the catalog.
Student’s Signature: ____________________________________________ Date: __________________
click to sign
click to edit