Department of Social Sciences

Departmental Petition/Approval Form

Student ID #:_________________________

Semester:_______________________________

Circle One Below:

Type of Course Number of Course -- 3 hr Number of Course -- 6 hr CRN
Field Experience SOS 4380 SOS 4680  
Special Projects SOS 4301 SOS 4601  
Directed Studies SOS 3399/4399    

Student Information:

Student's Name:
Address: City, ST: Zip
Telephone:  hm: wk: cell:
Email: GPA: Major:
Total Hours: Projected Graduation Date: 

Degree (check one): G  BS-IS      G  BS-PSY      G  BA-SOS      G  BS-SOS      G  BA-HIST

Brief Description of Project:
  
  
 
    

Signatures:

Student:
Faculty Coordinator:
Department Chair:

* attach project description