UNIVERSITY OF ILLINOIS AT SPRINGFIELD
Office of Records and Registration Individualized Course Title
Please complete, print (see "Print Form" button above), sign, and return this form to the Office of Records and Registration, University Hall, One
University Plaza, MS UHB 1076, Springfield, IL 62703-5407. Please be sure to carefully complete all information prior to printing the document.
Last Name First Name
Course Reference Number (CRN)
Credit HoursCourse Number
Records (217) 206-6709 Degree Audits (217) 206-8216 Registration (217) 206-6174 Graduation (217) 206-7730
For Office Use Only
You are currently enrolled in a research, tutorial, or independent study course that allows for an individualized title. Since you may feel it is
beneficial for an individualized course title to appear on your transcript, you may choose to complete this form and submit it to your instructor for
approval. Approved forms received in the Office of Records and Registration by the last full week of the semester will have the title entered on
the course at the end of the semester after grades have been posted. The individualized course title will then appear on your official transcript. The
completed form will then be placed in your permanent file in the Office of Records and Registration.
*Limit 30 characters, including spaces and punctuation. "Thes:" or "Proj:" must be included in the title of a thesis or master's project and be counted
as part of the 30 characters.
Instructor's Signature Date
Copies (distributed by the Office of Records and Registration):