UW DEPARTMENT OF ENGLISH – INDEPENDENT STUDY PROPOSAL
(ENGLISH 4620, 5975)
Student’s Name: __________________ W #: __________________
Student's Email: __________________ Semester/year: __________________
Name of Instructor: __________________ Today's Date: __________________
4620 5975: Please choose one # of credit hours: __________________
INSTRUCTIONS: To register for English 4620 Independent Reading or English 5975 Independent Studies, a
student must initiate a project with an appropriate faculty member and have it approved by the department chair as
described on this form. This proposal is to be written by the student and negotiated with the instructor and approved
by the department chair to their mutual satisfaction before registration. This form must be completed and filed with
the English Department main office. We will register students at that time. If the work below is not completed, the
student will receive a grade of F. ____________________________________________
OUTLINE OF INDEPENDENT STUDY TO BE COMPLETED (Title, readings, assignments, etc.):
_______________________________________________ ______________________________________________
Student Signature Instructor Signature
_______________________________________________
Department Chair Signature
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