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Boston College
Lynch School of Education
Readings & Research / Independent Study Proposal
Date: _____________________
Student’s Name: ___________________________________ Eagle ID: __________________________________
Year in Degree Program: ________ Degree program: ___________________________
† BA
Student E-Mail: ________________________________________________________
†
Master’s
Faculty Member Supervising Study: ________________________________________
†
PhD / EdD
Course Number: ____________________
Semester:
† Fall
† Spring
† Summer
Year:
† 2006
† 2007
† 2008
† 2009
† 2010
† 2011
Student and professor should discuss this proposal prior to its completion by the student. It must be signed by the
student and supervising professor and by the relevant Associate Dean (BA) or Department Chair (MA/PhD). Use
additional sheets as needed; entire proposal should not exceed 500 words.
1. Topic of your proposed study:
2. Objectives of your proposed study (list 2-3 major objectives):
3. Research and/or proposed activities in which you will be engaged to meet the above objectives:
4. Outcomes by which you will demonstrate that you have met the above objectives:
5. Nature and frequency of contact with the professor:
6. What educational objectives will this independent study meet that cannot be addressed by a course at BC or in the
consortia? Please explain using an additional page for details.
NB: The final evaluation report of Independent Study / Reading & research needs to be filed with the instructor and
with the Associate Dean (BA) or Department Chair (MA / PhD).
Signature of Student: ___________________________________
Signature of Professor / Instructor _________________________
Date _____________________
________
Approved
__________
Not Approved
____________
Date
Signature of Associate Dean for Students (BA) or Department Chair (MA / PhD)
_____________________________________________________ ________
Approved
___________
Not Approved
____________
Date
Office Use Only: Initial and date when student is registered: ___________________________________________
Office Use Only: Initial and date when student is registered: ____________________________________________
Once student is registered send 1 copy of this application to the Department Staff [ ], 1 copy to the supervising faculty
member [ ], and place 1 copy in the student’s file [ ].
Grade: Upon completion of the study, the supervising faculty member will assign the student a grade. The faculty
member is to submit his or her copy of this form to the Department Chair to post the grade.
Grade: _________________
Supervising Faculty Member (Please Print): _______________________________
Supervising Faculty Member’s Signature: _________________________________