JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Undergraduate Independent Study
Permission to enroll in PSC 480A will be given once this form is
completed
and all signatures are obtained.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name.
*
Your answer
Date.
*
Your answer
NSHE #.
*
Your answer
Telephone #.
*
Your answer
E-mail.
*
Your answer
Major.
*
Your answer
Standing.
*
Your answer
Semester & Year.
*
Your answer
Credits.
*
1 credit = 60 hours
2 credits = 120 hours
3 credits = 180 hours
Your answer
Hours.
*
1 credit = 60 hours
2 credits = 120 hours
3 credits = 180 hours
Your answer
Please discuss with the instructor before filling out this form and provide a curriculum plan below.
*
Ex. Books to read, term papers, critiques, etc.
Your answer
Please list the instructor administrating the Independent Study.
*
Your answer
Student's Signature.
*
Your answer
Instructor's Signature.
(PSC dept. will acquire the instructor's signature)
Your answer
Department Chair's Signature.
(PSC dept. will acquire the department chairs's signature)
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of University of Nevada, Las Vegas.
Report Abuse
Forms
