Request for acc 391C or 691c registration

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Request for ACC 391C or 691C Registration
Part I—To Be Completed by Student
Date: ______________________________________ Semester of Course: _________________________________
Name: _____________________________________ EID: _____________________________________________

(Last, First MI)

Degree Sought (circle): MPA PPA PhD (dept: ______________)
Graduate Advisor: ______________________________________________________________________________
Number of previous ACC 391C or 691C course hours counted toward degree: ______________________________
Number of previous BA 391 or 691 course hours counted toward degree: __________________________________
1. I request permission to enroll in ACC 391C Unique # ______________Professor: ________________________

or ACC 691C Unique # ______________Professor: ________________________

2. Detailed explanation of course content (topic, description, research, basis of grade, etc):

(Use reverse side if necessary)


Student Signature

Part II—To Be Completed by Instructor

3. Does the student have a “special academic need” not available in regular course of instruction? (Please Circle):

Yes No

4. Is this request consistent with the policy statement on ACC 391C/691C (Independent Study)?

Yes No

5. Do you recommend approval of this request?

Yes No

6. Any special comments? _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Faculty Signature--Must Be Member GSC: __________________________Date: ___________________________

Part III—To Be Completed by Graduate Advisor

Approved ________________________________ Not Approved ______________________________________

Graduate Advisor Signature: _________________________________________Date: ________________________

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