Independent Special Study Form
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1
2INDEPENDENT/SPECIAL STUDY FORM
HOLY NAMES UNIVERSITY
3500 Mountain Blvd., Oakland, CA 94619
FORMS MUST BE COMPLETED AND RETURNED BY THE SEMESTER AND/OR TERM ADD DEADLINE TO BE
ACCEPTED.
Date ______________________
Student Name ________________________________________ I.D.#
____________ 94/194/294/394 (Special Study) _______________ ________________________________ ______
Department
Course # and title of course the Special Study will replace Units
This is a regularly offered course required for graduation that is not being offered again before the student’s expected date of
graduation. The special study may be taught as a tutorial or to an individual student. Special studies are open to seniors, graduate
students, and others under extenuating circumstances. These courses are identified with the numbers 94/194/294/394.
__________________ 198/298/398 (Research) _________________________________________________________
Department
Course Title
Units
198 is the course number used for undergraduate research, and 298 for graduate thesis or directed Master’s project.
__________________ 199/299/399 (Independent Study) __________________________________________________
Department
Course Title
Units
This is an individual study not provided in regular courses, arranged by a student with a faculty member, and approved by the
Division/Department Chairperson and the Registrar. It may involve 1-3 units, and is listed on the transcript with the number 199/299/399
and with a descriptive title. Independent study is not available to freshmen or audit students.
This course is to be scheduled in: YEAR: ______________ (e.g.:2016) (Please appropriate box below)
Fall Semester
Spring Semester
Summer Semester
Fall Term 1
Spring Term 3
Summer Term 5
Fall Term 2
Spring Term 4
Summer Term 6
□
□
This course is to be taken for
Letter Grade
CR/NC
Advisor’s signature _______________________________________________
Date_________________________
Instructor’s name & signature ______________________________________
Date _________________________
Print last name
signature
Division Chair’s signature __________________________________________
Date _________________________
Registrar’s signature ______________________________________________
Date _________________________
Please complete both pages.
I understand that this class is subject to the same drop, add, incomplete and withdrawal policies as the courses in the regular schedule.
Student’s signature _______________________________________________
Date ________________________
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Student Resource Center, Hester Building, Room 11
|
3500 Mountain Boulevard
|
Oakland, California 94619
|
P : 510.436.1133
|
F : 510.436.1199
revised: May 20, 2016
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