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Request for Independent Study
CONTRACT FOR INDEPENDENT STUDY AND TUTORIAL
Requirements for Independent/Tutorial (Please attach syllabus, meeting times and other pertinent information)
| Name of Student: | |
| Major: | |
| Class Level: | Senior Junior GPA: |
| Faculty Sponsor: | |
| Semester for Study: | |
| Department: | Course Number: |
| Course Title: | |
| Number of Credits: |
| Topic of Independent Study/Tutorial: |
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Requirements for Independent/Tutorial (Please attach syllabus, meeting times and other pertinent information)
| Approved: | Signature | Date |
| Student: |
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| Faculty Sponsor: |
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| Faculty Advisor: |
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| Department Chair: |
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| Dean of the Undergraduate College: |
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