APPLICATION FOR BIO 499 INDEPENDENT STUDY
Student Information
Name: ________________________________________SID: _____________________
Major: ______________________________Concentration: _______________________
Credits Completed: ____________ GPA: _______________ Bio GPA: ______________
Faculty Supervisor: _____________________________________________________________
Title of Proposed Study:
Number of Credits:
Semester and Year of Study:
Brief Summary of Proposal:
Signatures
Student: _________________________________________________________Date: _______
Faculty Supervisor: ________________________________________________Date: _______
Ind. Study Committee Approval: _____________________________________Date: _______
IRB and/or IACUC Approval: ______________________________________Date: ________
Biology Chairperson: ______________________________________________Date: _______
Dean: ___________________________________________________________Date: _______