SIMON FRASER UNIVERSITY
FACULTY OF EDUCATION
Course Applied for: _________________________________ Semester: ____________________
Student name: _____________________________________ Student #: ____________________
Address: ______________________________________________________________________
_______________________________________________ Postal Code: ____________________
Telephone: (Home) _____________________________ (Work) __________________________
Previous Directed Study Courses completed:
EDUC ______ Title: _______________________________________ Completed: ____________
EDUC ______ Title: _______________________________________ Completed: ____________
EDUC ______ Title: _______________________________________ Completed: ____________
Signatures:
_______________________________________ Student Name - Please type or print |
______________________ Signature |
_______________ Date |
| _______________________________________ Cognate Faculty Supervisor - Please type or print |
______________________ Signature |
_______________ Date |
| _______________________________________ Instructor Name - Please type or print (if other than Supervisor) |
______________________ Signature | _______________ Date |
Office Use:
| Study Approved: | __________________________ |
| Study Rejected: | __________________________ |
| Date: | __________________________ |
***
Please provide a proposed academic course outline in
approximately
250 words:
Provide a bibliography and list of activities (if applicable) for the course:
Indicate the number and type of written requirements to be fulfilled by the student:
Attach a current unofficial SFU transcript.