Wesley College Independent Study Application
Student Name: _______________________ S.S.N.: _______________________
Course Name and Number: BBBBBBBBBBBBBBBBBBBBBBB Semester: ______________
Independent study is an arrangement between a student and a faculty member whereby the faculty member agrees to work
with the student on an individual basis in a program of supervised reading, research or creative work. Such study gives a
student an opportunity to explore a topic not incorporated in existing Wesley College courses or to explore a subject in
greater depth than is possible in a regular course.
Student must turn this completed form in to the Registrar’s Office AND register for the section of
Independent Study as a credit class at the same time. This must be done before the final day of the add/drop
period in the term in which the independent study course is to be taken.
The following guidelines govern all independent study courses at Wesley College:
1. A member of the faculty must agree to supervise the project and must certify by signing the application form that the
project involves an amount of legitimate academic work appropriate for the amount of academic credit requested and
that the applicant is qualified to pursue the project.
2. Application must include a syllabus of the course (MINIMUM 2 PAGES) that includes student learning outcomes,
course description, as well as assessments and assignments.
Application must also include one copy of the
student’s unofficial transcript.
OBTAIN SIGNATURES IN THE ORDER SHOWN
(1) Student: _____________________________________________ Date _______________
(2) Course/Independent Study Instructor: ____________________ Date _______________
(3) Advisor: _____________________________________________ Date _______________
(4) Department Chair: ____________________________________ Date _______________
(5) Registrar’s Office: ___________________________________ Date _______________
(6) Vice President of Academic Affairs: _________________________ Date _______________
Registrar’s Office will enroll student in Independent Study only after all signatures are obtained.
INDEPENDENT STUDY PRECONDITION CHECKLIST:
Conditions must be met before form is signed.
1) Student has a current cumulative G.P.A. of at least 2.5.
2) Student is currently a junior or senior.
3) Student has no incomplete grades on their transcript.
4) Student has no other independent studies this semester.
5) Independent study is not replacing a course offered in the same term.
Revised Nov. 2011
