INDEPENDENT STUDY APPLICATION
ATTACH THIS APPLICATION FORM SHEET TO YOUR PROPOSAL AND SUBMIT TO:
Dr. Donna Harrington, Ph.D. Program Director by e-mail to dharrington@ssw.umaryland.edu
All applications are reviewed by the PhD Program Committee (PPC) during regularly scheduled
monthly meetings or by e-mail during the summer or winter breaks. Applications for an
independent study should be submitted at least 4 weeks before the start of the semester to
allow time for review and revision (if needed) before the student must register.
NAME OF STUDENT: Click here to type
STUDENT’S SIGNATURE: Click here to type
NAME OF FACULTY SUPERVISOR: Click here to type
FACULTY SUPERVISOR’S SIGNATURE:
Click here to type
NUMBER OF INDEPENDENT STUDY CREDITS:
CREDITS (up to 3 credits allowed)
Semester applying for (please circle one): Fall Spring
Summer
YEAR: Click here to type
Independent study is designed to allow students to further their education in advanced areas
that are not provided in the courses offered by the School of the Social Work or elsewhere
within the USM where tuition remission is accepted. It allows a student to develop in-depth
knowledge that builds on the content covered in the required courses. The independent study
cannot be used for dissertation work or dissertation proposal development. However, the work
completed in an independent study may lead to a dissertation proposal.
Students are strongly encouraged to disseminate (i.e., present or publish) their independent
study work, as appropriate. If publication or presentation at a national conference is not
appropriate for the independent study product, then students are expected to present at the
Graduate Research Conference or other school based venue (e.g., an SSW lunchtime research
seminar, or Ph.D. program professional development seminar session).
All students and faculty supervisors are expected to discuss authorship of any products of the
independent study prior to signing this form. This discussion should include authorship order,
what is required to earn authorship, and roles after the independent study has ended (e.g., who
will be responsible for revisions, etc.).
Attach a course plan using the following headings and provide the information requested:
1. Title of the proposed independent study.
2. Brief statement of purpose of the independent study
Independent Study Application
Revised10/7/13
1
3. Does the duplicate or overlap existing courses at the SSW or in the USM where tuition
remission is accepted? If so, provide a justification as to why you are not taking the existing
course(s).
4. What coursework have you had that prepares you to complete the proposed independent
study successfully? (List courses and show how they prepare you for the work you are
proposing to do.)
5. List any other experiences you have had that have prepared you to conduct the proposed
independent study.
6. How does the proposed independent study fit into your overall educational plan?
7. List at least 3 objectives of the independent study.
8. What activities will be performed as part of the independent study?
9. What is the time frame for the proposed independent study? (Number of weeks.) How
many hours will you spend on the proposed independent study? How many hours will you
spend in face-to-face contact with the supervising faculty member? In general, credits are
based on a 15 week semester, and there should be approximately 3 hours of work per week
for every credit earned.
10. How will the independent study be evaluated? (Describe the items that will be graded, as
well as the grading criteria and methods; there must be at least two graded items.)
11. List readings that will be required as part of the independent study.
12. Please describe the plan for disseminating the independent study product(s).
PPC DECISION:
Approved for # of credits
Reject
Revise
COMMENTS:
Click here to type
Ph.D. Program Director signature
Independent Study Application
Date
Revised10/7/13
2