Individualized Instruction Form

Personal Information

First Name

Last Name

E-mail

Phone No

Course Information

Which course will you register for?:

Course

What semester will you register for this course?

How many credit hours will you register for this course?

Proposed Course Details

Graduate Degree Program

Professor's E-mail

I have already spoken with the instructor listed above about this course.

Please list 3 Course Objectives:

Please include a tentative reading list:

In the space below, please include a brief description of assignments that will be required in this course. Bullet points are OK (example: This course will result in a term paper, grant proposal, research design etc.)

In the space below, please briefly describe how the activities for this course will meet the requirement for the number of credit hours requested. A one credit hour course should have 45 hours of work. A two credit hour course should have 90 hours of work. A three credit hour course should have 135 hours of work.