Request for Independent Study (8910) Permit

 

Please complete this form to request approval and a permit for an independent study and submit completed form to Ph.D. office, FAB 426:
 
Student's Full Name:
SID: U
Semester:
Subject Area :
Description of Topic:
Is this a substitution for a required course? Yes     No
If yes, indicate the course (for example: MIS 8405)*
Name of Supervising Faculty:

 

APPROVAL SIGNATURES:

Signature of Supervising Faculty: ______________________________________

Concentration Area Coordinator: ______________________________________

* A course substitution form will be required to be submitted with your doctoral candidacy form.


Course section & CSN numbers below to be completed by PhD Programs Office

Course Section :_______________________________

CSN:_______________________________