STUDENT NAME: _____________________________CSU ID #: _____________________________

SEMESTER: __________________20_________ CREDIT HOURS: _________________________
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I. WHAT ARE YOUR OBJECTIVES FOR THIS INDEPENDENT STUDY?

II. WHAT WILL YOU DO TO ACHIEVE YOUR OBJECTIVES? WHEN WILL THESE BE COMPLETED?

III. HOW WILL YOUR FACULTY ADVISOR BE ABLE TO DETERMINE IF THE OBJECTIVES WERE ACHIEVED? (paper, oral report, other, et cetera)

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Graduate Coordinator Date

(09/02)