INDEPENDENT STUDY INFORMATION
College of Arts and Sciences
Attach a UAA Independent Study form to this CAS form and submit both to the CAS Dean’s office. Keep a copy of all paperwork in your department. The Dean’s office will keep the CAS form and syllabus material and return the UAA Independent Study form to your department to be picked up by the student and used to register for the course, if it is approved.
Semester_______ Year________
_________________________ _____________________ ____ _________________
Student’s last name First name MI Student ID #
IDEPENDENT STUDY
REQUEST
DOCUMENTATION ATTACHED:
1) COURSE TITLE &
DESCRIPTION
2) LEARNING GOALS AND
OBJECTIVES
3) SCHEDULE OF MEETINGS WITH
FACULTY MEMBER TEACHING THE COURSE
4) READING OR PROJECT GUIDE
(a list of suggested and/or required readings, or resources in the
Arts/Humanities)
5) ACTIVITIES OR PROJECTS
6) GRADING SYSTEM
7) OTHER RESOURCES TO BE MADE
AVAILABLE TO THE STUDENT (e.g., lab, software, study guides, notes, reserve
readings, videos/films, etc.)
Faculty Name (must be full time faculty)_______________________________________
(This person might only be the Instructor of Record who will assign the grade.)
If someone other than the above will actually be instructing or overseeing the student’s work, provide that person’s name_____________________________________
APPROVED_____ NOT APPROVED_____ DEPARTMENT CHAIR_____________________
DATE____________________