University of Arizona - Independent Study Course Request Form

Independent Study Course Request Form

PLEASE SUBMIT ONE REQUEST PER COURSE - DUPLICATES DELAY ENROLLMENT
Semester*
Year*
First Name*
Last Name*
University of Arizona Email*
PLEASE DO NOT USE YOUR PERSONAL OR WORK EMAIL (student@arizona.edu).
Program*
DNP Specialty*
Specialty
Course Number for Graduate Courses*
Units*
Faculty Name*
Email
example@example.com
List the main objectives of this independent study: *
List the desired outcomes of this independent study: *
If you are requesting enrollment in NURS 920 or 922, how many 920/922 units have you completed already?
Please include passed units and units currently in progress.
Faculty Member Approval

ApprovedNot Approved
Reason for Denial
Should be Empty: