Bristol Community College - Directed Study Approval Request

Directed Study: A Directed Study is an independent study or group study course, under the sponsorship of a faculty member that meets the objectives of a regular course offering. If a required course or its equivalent is not available, Directed Study permits a matriculated student to enroll in a course needed to graduate or to complete a prerequisite for another required course. Other requests may be approved based on special student or programmatic needs.
** Form must be completed electronically. All fields must be completed before the request will be reviewed. **
Requests should be submitted in time for final approval by the Financial Aid registration deadline. Requests must be approved by this date to avoid Financial Aid and course completion implications.
Student: Provide all information in this section, save the document and forward it. attached to an email from your Access BCC email account, to:
Name / ID#
Address
Provide number and street, town, state, and zip code
email / Phone Number
Matriculated Student? Yes No
Matriculated Program* / Option
*If you intend to complete another degree or certificate, please specify :
The above student is applying to take Course Number: and Course Title:
as a Directed Study.
Reason for requesting this course as a Directed Study:
Course will not be offered before expected date of graduation.
Course is needed as a prerequisite for other courses required in program.
Other - specify:
Check one: Day Student Evening Student Evening/Weekend Student
Main Location/mode: Attleboro Fall River New BedfordTauntonOnline Other, specify
The Directed Study experience will be completed during the (indicate semester and year)
Instructor/Divisional Dean: Complete this section, save, and forward to
During the period of the Directed Study, the instructor will meet/interact with the student for:
Number of Hours Per Week Per Semester Other, specify
Before initiating work with the student, the faculty member must discuss with the Divisional Dean plans for how the directed study will be completed, including a meeting/interaction plan and the syllabus, including proposed learning outcomes/objectives and assessment methods.
REQUIRED SIGNATURES
  1. Indicate approval/disapproval in email and enter “approved via email” or “disapproved via email” in email action space.
  2. Save form as attachment to email and forward to the next signatory.

Approved
Not Approved
Type Name / Email action - Associate Registrar / Date / Phone
Approved
Not Approved
Type Name / Email action- Divisional Dean / Date / Phone
I agree to teach this experience
Type Name / Email action- Instructor / Date / Phone
Approved
Not Approved
Type Name / Email action–Assoc. VPAc Affairs / Date / Phone

9-23-15