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College Online Policy and Procedure System

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Student Name:_______________________ Student Number:________________

Term, Year:_______, ________  Registration Number:___________

Prerequisite or Co-Requisite Survey Course or Introductory Course:__________

Credit Statement:
For satisfactory completion of the agreement, I will receive ___ credits of Independent Study:
 _______________, ____ 298. (Example: 3 credits of Independent Study: Biology, BI 298)
                 subject                      #
 
Project:
Describe the nature and the method of the independent study (research, survey, tutoring, etc.):
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Evaluation:
I understand I will be evaluated during the course of the term and upon completion of the Independent Study project, according to the guidelines of the discipline approved by Lane Community College.

Student signature:___________________________ Date: ___________________

Instructor signature: _________________________ Date: ___________________

Division Chair signature: ______________________Date: ___________________


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Lane Community College - College Online Policy and Procedure System
4000 East 30th Avenue, Eugene, OR 97405
Comments about Lane's Policy and Procedure System may be sent to Tracy Simms  copps@lanecc.edu
Date adopted:
     Date last reviewed:
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