ࡱ> x{w vbjbjR|R| 00 6,,,$PPPPP.7DCEEEEEE$F!ii,"7iE"8,CC=:/0"5("",ii]." : COLLEGE OF HUMANITIES, ARTS, BEHAVIORAL, AND SOCIAL SCIENCES INDEPENDENT STUDY/RESEARCH/INTERNSHIP CONTRACT (REV. 09/2016) A GENERAL INFORMATION1. STUDENT NAME2. STUDENT ID3. DAYTIME TELEPHONE4. CSUSM EMAIL FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      5. STUDENT STATUS (Check one):5a. MAJOR7. SEMESTER (Check one): FORMCHECKBOX  UNDERGRADUATE (Complete box 5a)  FORMCHECKBOX  GRADUATE (Complete box 5b) FORMTEXT       FORMCHECKBOX  FALL 20 FORMTEXT     FORMCHECKBOX  SPRING 20 FORMTEXT     FORMCHECKBOX  SUMMER 20 FORMTEXT   5b. GRADUATE PROGRAM FORMTEXT      B COURSE INFORMATION8. COURSE ABBREVIATION AND NUMBER9. Class #10. # OF UNITS11. SUPERVISING TT FACULTY FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      C CONTRACT INFORMATION (Additional documentation may be attached)12. TOPIC OF STUDY FORMTEXT      13. TENTATIVE OUTLINE OF WORK  FORMTEXT      14. WORK TO COMPLETE FOR A FINAL GRADE FORMTEXT      15. IS THIS COURSE APPROVED TO SUBSTITUTE FOR A MAJOR/MINOR REQUIREMENT?15a. MAJOR/MINOR REQUIREMENT FORMCHECKBOX  NO  FORMCHECKBOX  YES (Complete box 15a) FORMTEXT      16. Course Attribute:  FORMCHECKBOX  Internship  FORMCHECKBOX  Service Learning  FORMCHECKBOX  Research  FORMCHECKBOX  Independent Study NOTE: Registration of this contract may result in a change of enrollment status and require additional fees. Please check your Student Center (My) daily to learn the status of enrollment in this course.D AUTHORITY SIGNATURES (This certifies that the student has met any prerequisites for this course)SUPERVISING TENURED/TENURE-TRACK FACULTY SIGNATUREDATE% FORMTEXT      DEPARTMENT CHAIR/PROGRAM DIRECTORDATE% FORMTEXT      DEAN/DEAN S DESIGNEE (required beginning the 4th week of the semester)DATE% FORMTEXT      INSTRUCTIONS 1. 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Enter 9 digit student ID number assigned by university. 3. Enter telephone number where student can be reached during university business hours. 4. Enter university assigned e-mail address. 5. Check the status of the student; undergraduate or graduate: 5a. For undergraduate students only 5b. For graduate students only 7. Check the semester and enter the year of this course. 8. Enter the course abbreviation and number (i.e. COMM 310). Refer to university catalog and faculty member for course number and suffix. 9. Enter the 5-digit class number. In many cases this can be left blank. 10. Enter the number of units for the course (most course number suffix s follow this rule: A=1 unit, B= 2 units, or C=3 units. 11. Enter the name of the TT faculty supervising the course. Only tenured/tenure-track faculty can supervise independent studies. 12-16. Work with the supervising tenured/tenure-track faculty member to complete section C & D. RETURN COMPLETED FORM TO COUGAR CENTRAL (CRA 3900). 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