Independent Study Proposal
College of Human Ecology
STUDENT: Prepare this form electronically and present a hard copy for signatures. All signatures must be
obtained before the independent study can be registered in Banner and the work begins. The student
must be enrolled in the semester in which the independent study work is undertaken. Independent
study involves one-on-one mentoring of a student by a faculty member.
COURSE SUBSTITUTION: Independent study should not be used to replace courses that are regularly
offered, except in extraordinary circumstances (e.g., two required courses are offered at the same time
during a student’s final semester before graduation).
Student Name:
ECU Banner ID: B00
Local Address:
Cell Phone:
Home Phone:
Email(s):
Term/Year
Faculty Supervisor:
Course Prefix:
Course Number:
Section Number:
CRN:
*Semester Hours:
Title of Course:
PROGRAM OF STUDY: It is the student’s responsibility to consult with his/her advisor regarding
application of credit hours earned via Independent Study to their Program of Study.
*CREDIT HOUR DETERMINATION: Use the following information to identify the approximate number of
hours required for each semester hour earned.
1 cr = 60 hrs of work
2 cr = 120 hrs of work
3 cr = 180 hrs of work
GOAL(S) OF INDEPENDENT STUDY: (Insert or attach a description no longer than 300 words of what is to
be accomplished through the independent study.)
LEARNING OUTCOMES: Identify at least three outcomes that describe the knowledge you will learn or
the skills you will develop by the conclusion of the independent study.
At the conclusion of the independent study the student will be able to:
1.
2.
3.
TASKS: Insert or attach an itemized list of tasks you will undertake to accomplish the learning outcomes.
Include the estimated total time it will take and the due date for each task. Typically, one item will be
keeping a log of hours spent doing all aspects of the independent study. Tasks might include reading and
research, interviews with professionals, writing a paper or final report about what was learned, etc.
START DATE OF THE INDEPENDENT STUDY:
TASK TO BE UNDERTAKEN
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
END DATE OF INDEPENDENT STUDY:
DUE DATE
HOURS OF
TIME
TOTAL HOURS:
EVALUATION: Insert or attach an explanation of how the independent study will be evaluated and
graded. Indicate the standards required to achieve a particular grade and identify the weightings for
tasks or products. The student, the faculty member, or both may propose the grading and evaluation
processes.
SIGNATURES:
_____________________________________________________________________________________
Student
Date
_____________________________________________________________________________________
Faculty Supervisor
Date
_____________________________________________________________________________________
Other (if applicable) Title
Date
_____________________________________________________________________________________
Unit Head
Date