LIBERAL & INTEGRATIVE STUDIES
BLUE FORM
(LIS/LNT) INDEPENDENT STUDY FORM
and Permission for Individualized Instruction
This form should be used for all independent studies, tutorials, internship, and experiential work designed for
academic credit in the Liberal and Integrative Studies (LNT graduate) and Liberal Studies (LIS undergraduate)
Program. After negotiating the content and process with a faculty sponsor, this form should be completed and sent
to the LNT Secretary.* The student will be instructed to register pending approval of the college dean.
Se le ct th e a p p r op r ia te co ur se p r efix a n d n u m b er
LIS
Undergrad
course
C R N ( to b e a ssig n e d )
380 Learning Resources (Project 2-8 hrs)
4 9 9
T u t o r i a l
( 4 - 6
h r s )
LNT
Graduate
course
580 Tutorial (2-12 hrs)
599 Field Project (2-12 hrs)
Student
Date
UIN
UIS Email
Are you admitted to UIS as an online student?
Status
Term
Fall
Spring
Summer
Yes, all online
20 __
Credit Hours
No, some on campus
__
Proposed
title
No more than 30 characters, including spaces and punctuation
P R O J E C T A P P R O V AL ( S t u d e n t s , d o n o t w r i t e b e l o w t h i s l i n e )
Faculty
Signature
(I agree to sponsor this project/study compensation in excess of 100% @ $100.00/credit hour)
Date
Assigned to the college of
Faculty
Liberal Arts Sciences
Business Management
UIN
APPROVED BY
SIGNATURE
Public Affairs Administration
Education Human Services
DATE
Student Adviser
LIS Director or
LNT Department Chair
Dean Approval
Signed copies to
*Mail to University of Illinois Springfield
One University Plaza UHB 3038
Springfield, IL 72703
Dean
LNT Program
VCAA
Fax to 217-206-6217 Attention LIS/LNT
or, scan to pdf and email to
lpric01s@uis.edu
Rev. 4/11
LIS AND LNT INDEPENDENT STUDY PROPOSAL INSTRUCTIONS
A typical 4-credit-hour course meets 3 ½ hours per week for 16 weeks (56 hours). A typical student spends
2 hours outside of class reading, preparing for exams, writing, etc., for every hour in class (112 hours). So,
if you’re a typical student, you’ll devote 168 hours to a typical 4-credit-hour course. Use this and your own
past experience in arriving at a reasonable agreement with your faculty sponsor regarding credit hours for
the project.
LIS refer to Chapter 13 in the undergraduate handbook.
LNT refer to Chapter 11 in the graduate handbook.
After negotiating the content and process with a faculty sponsor, this form should be completed and sent to
the LNT Secretary.* The form will be signed by the faculty sponsor and LNT Director prior to registration. If
you are using an external resource, it is your responsibility to get that signature. You may attach additional
pages to this form as needed.
Attach a detailed course description addressing each of the following points
1.
OBJECTIVES: What is the nature of the project? What do you want to learn?
2.
RATIONALE: Why? (Refer to Goals, and Learning Needs)
3.
RESOURCES: Resource People (Provide Information about relevant qualifications or interests)
4.
BIBLIOGRAPHY: (List author, title, publisher, and date) Finally, location(s) and facilities
5.
WORK PLAN: What steps will you follow in carrying out your study?
6.
TENTATIVE SCHEDULE: Within the narrative statement, give approximate dates of when you
expect to complete each section or part of your study.
7.
DOCUMENTATION: How will you demonstrate to the Instructor that you have met your objectives?
(e.g., term paper; other product, oral examination).
8.
EVALUATION: What criteria should be used to evaluate your performance? (e.g., comprehension,
creativity, insightfulness, scholarship, other)
9.
SCHEDULE: The final element of your narrative essay is to include dates for the midterm report and
final faculty meeting
*Mail to: University of Illinois Springfield
One University Plaza UHB 3038
Springfield, IL 72703
Fax to: 217-206-6217 Attention LIS/LNT
or, scan to pdf and email to
lpric01s@uis.edu
Rev. 4/11