Independent Study Request Form

This form should only be used to create independent study courses from COEHHS & COBA.

Please see the Schedule Forms page for directions on how to make other schedule changes. The submitter's email listed below will be sent a confirmation email after submission.

This form is to ONLY be filled out by Academic Coordinators or Department Chairpersons (This is NOT a student form).

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W
R
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ONLINE
ARR

ARR indicates the time will be arranged between faculty & student.

Please use Military Time (e.g. 1600 instead of 4:00PM)

Please use Military Time (e.g. 1715 instead of 5:15PM)

Indicate How Many Units the Class Will be Worth (e.g. 3.0)
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Indicate the Capacity of the Class
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Indicates whether the section shows up on the Class Schedule

Indicate How Many Needed (e.g. 10)

MM/DD/YYYY Will be the last day of the term if left blank
No
Yes

Indicated if this course should have a Waitlist



Put text of note in comment box

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Submitter's Full Email (e.g. jsmith@csusm.edu)

Indicate if you would like other individual(s) CC'd upon completion of request
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