Microsoft Word - Ind Study App.docx
Eastern Illinois University School of TechnologyApplication for Independent StudyStudent Name:E‐Number:EIU Email:Phone:Major:Supervising Faculty Name:Semester/Year of Independent Study:Course Title (i.e., DGT 3920, DGT 4444, TEC 5990):Number of Credit Hours:Title of Independent Study Project:Outline of Experience and/or Research:Student and supervising faculty member have agreed to the following evaluation procedure:Supervising Faculty Signature:Date:Academic Advisor Signature:Date:Chair Signature:Date: ................
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