Fillable form to the Registrars Office with all signatures. (Millikin University)

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form to the Registrars Office with all signatures. (Millikin University)

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The form to the Registrars Office with all signatures. (Millikin University) form is 1 page long and contains:

  • 5 signatures
  • 4 check-boxes
  • 26 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Millikin University

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Student Name:__________________________ Term: Fall___ January___ Spring___ Summer___ Year________
Student ID: __________________ Major 1__________________ Major 2____________________
Directions: Please select the type of study you plan to undertake and fill out the appropriate sections. Return the completed
form to the Registrar’s Office with all signatures. Please also include the learning goals/syllabus for the course.
I have discussed this fully with my faculty supervisor and have agreed upon the content and terms needed to
complete this course satisfactorily.
Student’s Signature Date Advisor’s Signature Date
Supervising Faculty Signature Date Department Chair’s Signature Date
Dean’s Signature Date Director of January and Summer Immersion Date
(Required only if plan of study occurs during the January
or Summer Immersion Term)
Version 7/2017
Individual Study Contract
Traditional Undergraduate Program Only
Fee Structure
Consult the current Academic Year Bulletin or January/Summer Term Catalog for the fee structure which applies to your option
indicated below.
INTERNSHIP
Course Title:____________________________________________________
Company/Organization:___________________________________________
City/State/Zip:___________________________________________________
Supervisor’s Name:_______________________________________________
Department:______________ CRN/Course Number (assigned by Registrar)__________________ Credit Hours_______________
INDEPENDENT STUDY
Course Title:____________________________________________________
Supervising Faculty’s Name:________________________________________
Department______________ CRN/Course Number (assigned by Registrar)__________________ Credit Hours_______________
DIRECTED STUDY
Course Title:____________________________________________________
Supervising Faculty’s Name:________________________________________
Department______________ CRN/Course Number (assigned by Registrar)__________________ Credit Hours_______________
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form to the Registrars Office with all signatures. (Millikin University)

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Completed 23 August 2020

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