What request form will you be completing?*REQUEST FOR FCEDS INDEPENDENT STUDY EXPERIENCEREQUEST FOR HD FS INDEPENDENT STUDY or RESEARCH EXPERIENCEREQUEST FOR HD FS FIELD EXPERIENCESStudent:* First Last Email:* Classification:*FRSOJRSRSemester of experience:FallSpringSummerYear of experience:*Please enter a number from 2020 to 2030.Credits:*123456789INDEPENDENT STUDY or RESEARCH EXPERIENCE490 Independent Study490H Honors499 ResearchINDEPENDENT STUDY FCEDS490G Independent Study: GeneralHonorsCr. 1-6. Prereq: permission of instructor. Graded S-F. HD FS 317317B Field Experiences: HDFS317H Field Experiences: HonorsMay be used for an Undergraduate Teaching Assistantship (UTA) Assignment. Consult department office for proceduresHD FS 490. Independent Study. Cr. arr. Prereq: 6 credits in human development and family studies. Graded A-F. HD FS 490:May be used for an Undergraduate Teaching Assignment. Consult department office for procedures HD FS 499. Research. Cr. arr. Repeatable, maximum of 6 credits. F.S.SS. Prereq: Consult department office for procedures. Supervised research experience. Graded A-F. ATTACH a description of the independent study or research experience and requirements (to be completed by the instructor of record in consultation with the student – include student learning outcomes, activities to be completed, a timeline/ conferences with faculty supervisor and an explicit plan for grading/assessment expectations). Use a department syllabus template to cover these requirements. STUDENTS MAY BE ASKED TO COMPLETE Institutional Review Board - IRB Training for research projects. FCEDS 490. Independent Study. Cr. arr. Prereq: 6 credits in human development and family studies. Graded A-F. FCEDS 490: May be used for an Undergraduate Teaching Assignment. Consult department office for procedures ATTACH a description of the independent study or research experience and requirements (to be completed by the instructor of record in consultation with the student – include student learning outcomes, activities to be completed, a timeline/ conferences with faculty supervisor and an explicit plan for grading/assessment expectations). Use a department syllabus template to cover these requirements. STUDENTS MAY BE ASKED TO COMPLETE Institutional Review Board - IRB Training for research projects. ATTACH a description of the proposed field experience and requirements (to be completed by the instructor of record in consultation with the student – include student learning outcomes, activities to be completed, a timeline/ conferences with faculty supervisor and an explicit plan for grading/assessment expectations). Use a department syllabus template to cover these requirements.FileApproved by:Student*(Student: Printed Name)*(Student: Signature)* Date Format: MM slash DD slash YYYY (Date)Adviser*(Adviser: Printed Name)*(Adviser: Signature)* Date Format: MM slash DD slash YYYY (Date)Instructor of Record*(Instructor of Record: Printed Name)*(Instructor of Record: Signature)* Date Format: MM slash DD slash YYYY (Date)Director of Undergraduate Ed.*(Director of Undergraduate Ed.: Printed Name)*(Director of Undergraduate Ed.: Signature)* Date Format: MM slash DD slash YYYY (Date)Department Chair*(Department Chair: Printed Name)*(Department Chair: Signature)* Date Format: MM slash DD slash YYYY (Date)Completed form must be signed by student, academic adviser, instructor of record, and the DUGE, and then submitted to the Department Chair (2330 Palmer Building) no later than the week before registration for the semester in which the credit is sought. Following the Department Chair’s approval, an e-mail indicating the registration reference number will be forwarded to the student, academic adviser and instructor of record. If the form is complete, please submit. Otherwise, select Next Steps (Save and Continue) and follow the instructions.