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Graduate Independent Study Application

First Name:

Last Name:

Email Address:

Phone Number:

Penn ID #:

School:

College of Arts and Sciences

Nursing

Engineering

Wharton

Liberal and Professional Studies

Other

Proposed Project Title:

Professor

First Name:

Last Name:

Department:

Email Address:

Project Description

Proposed Project Description:

(Must include required readings, assignments, and semester’s meeting schedule.)

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