Request for ACC 391 Or 691 Registration

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: ______