Directed Independent Study Contract (DIS)
Name of Student: _______________________________________________________ Semester/Year: _________________________
Student ID: _______________________________________ Phone: ________________________________________
E-mail: _________________________________________________________ Major: _____________________________________________
Student is within 16 hours of graduation: Yes No
Directed Independent Studies Course: __________________ Instructor:____________________________________________
Course CRN: __________________________________
Why is this DIS Necessary?
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_________________________________________________________________________________________________________________________
Grade Determination and Responsibilities of the Student:
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Faculty and student will meet according to the following schedule:
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_________________________________________________________________________________________________________________________
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Student Signature Date
Instructor Signature Date
Division Dean’s Signature Date
Updated 6/08/2020
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