MBA PROGRAM
ACADEMIC-BASED / RESEARCH-BASED
INDEPENDENT STUDY REQUEST FORM
The Academic-Based or Research-Based Independent Study is the means to pursue and register for a personallydesigned learning project.
To be able to enroll in an Academic-Based or Research-Based Independent Study project you must:
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Discuss your idea with the Director of Student Affairs (Tim Hossain – Evening MBA students, Sigrid Olsen –
Full-time MBA students). Before scheduling a meeting you should review the Academic/Research- Based
Independent Study Proposal Template.
Submit an Academic /Research-Based Independent Study Proposal to the MBA Program Office for review
and approval.
Upon approval of the proposal, secure a faculty member to sponsor your independent study.
Complete the Independent Study Request & Project Agreement form.
Drop off the Form & Agreement, with Proposal attached, at the MBA Program Office.
Register for independent study credits no later than the end of the first week of the quarter (per academic
calendar) for 4-credit projects or the end of the third week of the quarter for 2-credit projects.
Note: Grades in 600-level classes will appear on your grade sheet and UW transcript, but are not calculated into your
cumulative GPA.
Section to be Completed by the Student
Name: _______________________________________________________________Student ID#: ____________________
UW Email: _________________________________ Program: □ Full-time MBA □ Evening MBA
Academic Quarter: □ AUT □ WIN □ SPR □ SUM Year:___________
Type of Independent Study: □ Academic-based □ Research-based
Project Credits: □ 2 Credits □ 4 Credits
Faculty Sponsor:_____________________
MBA Program Office Use Only:
MBA Program Office Approval:___________________________________________________
Registration Processing
Date Received: ________________ Staff Initials______________
Faculty Dept Prefix:________________________ SLN:_______________________________Faculty Code:_________________
Date Registration Information/Confirmation Sent to Student:________________
Revised July 2015
MBA PROGRAM
ACADEMIC-BASED / RESEARCH-BASED
INDEPENDENT STUDY
PROJECT AGREEMENT
Please provide information to reflect the mutually-agreed upon understanding of the project between you and your faculty
sponsor as guided below. Attach additional information as necessary. Both you and your faculty sponsor must sign and date to
indicate agreement.
Independent Study Credits:
□ 2 Credits (Approximately 60-80 hours of work during quarter)
□ 4 Credits (Approximately 120-160 hours of work during quarter)
□ Project Proposal Attached
Your project proposal must be reviewed and signed by the Director of Student Affairs and your Faculty Sponsor BEFORE you
turn it into the MBA Program Office to register for the credits. If the scope of work outlined in your project proposal changes at
any point throughout the duration of the project, you must update your proposal and share the updated copy with your faculty
sponsor and the MBA Program Office.
Required Meetings with Faculty Sponsor
Please list the date and times of at least three scheduled meetings with your faculty sponsor.
1.
Week 3:___________________________________________________________________________________________
2.
Week 6:___________________________________________________________________________________________
3.
Week 9:___________________________________________________________________________________________
Agreement
Student Signature:
Faculty Signature:
________________________________Date________
____________________________________Date________
Printed Name:
Printed Name:
_____________________________________________
__________________________________________________
Revised July 2015