Independent Study Course Request Spring 2023

Semester*

Year*

First Name*

Last Name*

Student Email*

DNP Specialty*

Specialty

For DNP/PhD students only. Please review the following, and check the box if the statement applies:

I am a Graduate Assistant (GA) or Teaching Assistant (TA) or Research Assistant (RA) during this term, and have filed the required paperwork to receive my benefits.I am receiving QTR tuition benefits.I am a recipient of the Graduate College's Dissertation Tuition Waiver (for non-WRGP out-of-state students), and have submitted by request to Graduate Student Services.

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: *

Faculty Member Approval

ApprovedNot Approved

Reason for Denial