Coordinated Study Application

The student must be a junior or senior with exceptional circumstances which do not allow enrollment in a classroom or Extended Campus version of the course to take a coordinated study.

The Program's Dean must approve all Coordinated Studies.

Name*

First Name

Last Name

Student Identification #:*

Site:*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Phone*

Email*

Course ID*

Course Name

Reason for requesting a Coordinated Study*

Choose Term*

Payment Options*

Financial Aid Military National Guard Company Letter Other

Prerequisites

Other CS and terms

Hours this term and semester

Failed Courses