Student ID
Course Authorization Form number _______________
Independent Study, Focused Study, Special Directed Study
Independent Study - created by undergraduate or graduate student in collaboration with a Cambridge College faculty
sponsor. Content must not duplicate existing Cambridge College courses.
Focused Study – CC undergraduate course needed by student in a term when it is not offered. Authorized by the dean.
Depending on external regulations, may be required to meet requirements of a scheduled on-seat course.
Special Directed Study – CC graduate course needed by student in a term when it is not offered. Authorized by the dean.
Shows on transcript as a regular course. Licensure course content requirements remain unchanged.
Student
Last Name ________________________________ First Name_________________________ Middle Name______________________
Faculty assigned________________________________________________________________ Term/Year______________________
Independent Study Title OR
CC Course number and title__________________________________________________Number of Credits______________________
COURSE or STUDY DETAILS Describe below. Type under each heading (form will expand) or attach separate pages.
Rationale: Why is this course/study necessary?
Type here:
Course Description/Study Content
Type here:
Objectives/Goals
Type here:
Contact Hours (15 hours of faculty-student interaction required per credit hour; typically no less than 37.5 hours/3 credits)
Contact hours may be met through a combination of meetings between instructor and student, attendance at workshops or segments of
courses covering aspects of the content (with instructor's permission), or participating in other academic activities external to the
classroom that are directly guided by a faculty instructor. Faculty sponsor and student will agree on how the full contact hours will be
accomplished.
Type here:
Methodology (e.g. reading, research, case studies, journal articles, internet resources, consultation with advisor)
Type here:
Assignments/Projects
Type here:
Resources (e.g. required and recommended readings)
Type here:
ACADEMIC INTEGRITY See policy at www.cambridgecollege.edu/academic-integrity
The student understands and agrees to abide by the Cambridge College standards of academic integrity. All work must be completed
by the individual student’s own honest academic effort. Students will not summarize, copy, or use the work, thoughts, or language of
another person or source without proper acknowledgement. It is not permissible to hand in the same work for different courses. Any
breach of academic integrity is grounds for a grade of "No Credit" and/or dismissal from the College.
SIGNATURES Get all handwritten signatures below indicating approval, OR attach printouts of emails giving approval.
Student____________________________________________________________________________ Date______________________
Faculty____________________________________________________________________________ Date______________________
Academic Advisor/Seminar Leader______________________________________________________ Date______________________
Regional Center Director (if applicable) ___________________________________________________ Date______________________
International Student Advisor (if applicable)________________________________________________ Date______________________
Academic Dean/Designee_____________________________________________________________ Date______________________
After signatures are complete, submit original to Registrar’s Office:
Fax 617-349-3560 email:
[email protected]Copies:
Student – keep copy for your records; you will see entry on your updated course schedule from the online system
Center director – send form to dean for final sign-off
Bursar – bill student based on the entry in the online system (no paper copy needed)
Dean – keep copy for your records as desired Rev. 1/25/17
