UNIVERSITY OF SOUTH CAROLINA AIKEN
INDEPENDENT STUDY CONTRACT
ALL REQUIRED SIGNATURES MUST BE OBTAINED PRIOR TO REGISTRATION.
Student’s Name (Print): __________________________________________ Local Phone: ________________________________
VIP ID#: ______________________________________________________ Major: _____________________________________
COURSE:
TERM:
B
I O
Department
L
Prefix
Fall
Spring
Course No.
Suffix
Summer I
Section
Credit
Summer II
Schedule Code
Year
Instructor’s Name (Print): ___________________________________________________________________________
THIS SECTION TO BE COMPLETED BY THE INSTRUCTOR WHO WILL SUPERVISE THE STUDY.
COURSE TOPIC:
(Will appear on
Academic Record)
Course Summary and Objective:
Textbooks, Readings, or other sources to be used:
Method of Evaluation (check all that apply):
Oral Presentation(s)
Formal Lab Book
Satisfactory Lab Performance
Written Report
Research Proposal
Lab Meeting Attendance _____%
Additional comments:
_____________________________________________________________
Instructor’s Signature
Complete the following if applicable to the project:
Human Subjects: IRB (Institutional Review Board ) Approval #_____________________________ Date___________________
Vertebrate Lab Animals: Animal Use Approval ( IACUC) Approval #________________________ Date___________________
Recombinant DNA: IBC (Institutional BioSafety Code) Approval #__________________________ Date___________________
I certify that this Independent Study: (
) will be used as part of my:
(
(
) Major (
) Minor (
) Cognate
(
) BAIS/ BSIS Concentration
) will not be used as part of my major, minor, or cognate.
I understand that completion of this form does not constitute registration, and that I must register for this course with the Office of the Registrar.
Student is to present original copy to the Office of the Registrar to complete registration.
____________________________________________________________________
Student’s Signature
____________________
Date
____________________________________________________________________
Advisor’s Signature
____________________
Date
____________________________________________________________________
School Head/Department Chair Offering the Course
___________________
Date
Other