Directed Study Request
Full Name
*
First
Last
Email
*
example@example.com
Faculty Advisor Email
*
example@example.com
Term:
*
Course Number
*
example: BT 100
Course Name
*
Instructor who is directing the study:
*
Instructor Email
*
example@example.com
Reason for wanting to take this course by Directed Study:
*
Date the course is to be completed:
-
Month
-
Day
Year
To be completed by the instructor
The meeting plan for the directed study (how often, day, time:
To be completed by the instructor
List of all requirements to be met by the student, including reading, assignments, and exams. (If following requirements in the regular class syllabus, that may be attached and noted here.)
To be completed by the instructor
Student Signature and Date
*
Faculty Signature and Date
This form
must
be completed and submitted to the Registrar prior to starting the course.
Jani Email
example@example.com
Submit
Should be Empty: