INDEPENDENTSTUDYLEARNINGCONTRACT Department or Curriculum Name: PHILOSOPHY
Course #: PHIL 396CreditHours:3.0
List prerequisites (if applicable):
SectiontobecompletedbyStudent
APPLICANTINFORMATION:
Student Applicant’s Name:
PID:
E‐mail:
Phone #:
Dateof Application:
Credit HoursSought:
Major:
Class:SENIOR☐JUNIOR☐SOPHOMORE ☐FIRSTYEAR ☐
SemesterRequested: FALL ☐SPRING☐SUMMER I☐SUMMER II☐YEAR
CurrentGPA: CUMULATIVE
MAJOR
Prerequisite(s) Fulfilled: COURSE#
COURSE#
SEMESTER/YEAR
SEMESTER/YEAR
GRADE
GRADE
SectiontobecompletedbyStudentandFaculty
INFORMATIONABOUTINSTRUCTOROF RECORD:
Name:
E‐mail:
Instructor’s IndependentStudy Section #:
Check One:
For thiscoursethefaculty memberhas nomorethantwostudents persemesterorsummersession.
For thiscoursethefaculty memberhas morethantwostudents persemesterorsummersession. The reason for theexceptionis (FILLIN):
COURSEREQUIREMENTS.Thisisconsidereda contractbetweentheinstructor(advisor/sponsor)and thestudent. Deviations fromthiscontractshouldbeupdated and documentedtotheextentpossible by theinstructorand student.Students areexpectedtodevoteatleast threehours of independent workperweekfor eachunit of credit (e.g.,9hoursperweekif 3credithours).
a) Meetingrequirementswith theinstructor(e.g.,individual meetings,labmeetings,etc.).Include day/time of weeklyorbi‐weeklymeetings.
b) Reading assignments (and due dates,if relevant): c) Writtenassignments (pagerequirements/limitsand due dates,if relevant): d) Other assignments (pleasedescribe):
e) Assessment(e.g.,%of coursegradebased on eachrequirement)includingfinal examination (or alternate format):
Student,FacultyandAdministrativesignatures
INSTRUCTOROF RECORD AND STUDENTRESPONSIBILITIES:
Ihavereadtherequirementsexpectedof theinstructor, agreetoundertaketheseresponsibilities, and will abide by theHonor Code’s responsibilitiesof faculty.
Instructor
Date
Ihavereadtherequirementsexpectedof thestudent, agreetoundertaketheseresponsibilities, and will abide by theHonor Code’s responsibilities of students.
Student Date
* INDEPENDENTSTUDYCOORDINATOR:
Thisapplication for Independent Study has beenreviewed.The proposalis
☐APPROVEDAS IS
☐REQUIRESMORE INFORMATION(provide detailsand returntoinstructorand student)
☐NOTAPPROVED(provide rationale)
School/Department/Program Independent Study CoordinatorDate
* If theIndependent Study Coordinator is not theDepartment/Curriculum Chair, theDirectorof Undergraduate
Studies(DUS), oranother Faculty Designeeof theChair, thentheChair ortheDUSmust alsoapprovethiscontract.
** CHAIROR DIRECTOROF UNDERGRADUATESTUDIES(whicheverisapplicable):
Thisapplication for Independent Study has beenreviewed.The proposalis
☐APPROVEDAS IS
☐REQUIRESMORE INFORMATION(provide detailsand returntoinstructorand student)
☐NOTAPPROVED(provide rationale)
Chair/Directorof UndergraduateStudies/FacultyDesignee/SADDate
** If theChair is thestudent’s independent study instructor,thisformmustbesignedby theChair’sSenior
Associate Dean (SAD).
Note:Departments/Curricula mustmaintain copies of thiscontractfor a minimum of four years.
[Typetext]
3/22/2013