Application for an Independent Study
No student may take more than two independent study courses during a four-year period. Before filling out this form,
students should contact their major department office for specific guidelines regarding independent study.
A student must have a minimum cumulative gpa of 2.5 in order to qualify for an independent study course.
Some departments require a higher gpa. Check your department’s requirement in this regard.
Students must write out a proposal and then discuss it with their chosen sponsor. If they have not chosen a sponsor, they
may ask the department to recommend one. After student and sponsor have signed the form, they must submit the proposal
to the department office and then an academic dean for approval. The department office, the dean’s office, the facultysponsor and the student should each retain a copy of the proposal. At the end of the semester, the sponsor should complete
the evaluation and send a copy to the dean’s office for the student’s file after reporting the student’s grade to the registrar.

Student’s Name: __________________________________________

ID: ___________________

Major: __________________________________________________CUM GPA: _____________

Faculty Sponsor’s Name: ___________________________________
Semester: _____________

Department: _________________

Course Number: __________-------------------------------------------------------------------------------------------------------------------------------------------Independent Study Course Proposal ​ (Use​​additional sheet of paper if necessary to complete this section)
TOPIC FOR ANALYSIS:METHODS OF ANALYSIS AND RESOURCES:READING LIST:INDEPENDENT STUDY COURSE REQUIREMENTS​ (e.g. number of papers, meetings with professor, graphs orstatistical data, oral presentation, final examination, etc.)

Revised Aug.2019- Independent StudyFaculty Sponsor
I have met with ____________________________ and discussed the above proposal.
(student​name)

In signing this form, I agree to sponsor this student and to evaluate this student’s learning as outlined above.
_____________________________________________________________

Faculty​sponsor’s signature

DateStudent
I have met with _________________________________ and discussed this proposal.
(instructor’s name)

In signing this form, I agree to fulfill the requirements outlined above within the given academic semester.

_____________________________________
Student signature_______________________
Date

Academic Dean
I have reviewed this independent study course proposal and find its conditions satisfactory for earning academiccredit.
____________________________________________________________

Dean’s signatureDate-----------------------------------------------------------------------------------------------------------------------------------------------Review at the end of Semester
I have reviewed the semester coursework of _______________________________ and attest that he or she​ (student​name)has completed this independent study course. I have also submitted the semester grade to the Registrar.
Grade assigned: ​_______________________________________________________________________

Faculty sponsor’s signature

DateSubmit​
completed form to the Undergraduate Office in 107 McMahon Hall or as-ugprogramsoffice@cua.edu​Revised Aug.2019- Independent Study