Department of Foreign Languages and Literatures
Virginia Polytechnic Institute and State University
Field Study and Senior Tutorial
2964, 4964, and 4794
STUDENT INFORMATION COURSE INFORMATION
1) Name: , 1) Department: ,
2) Student Number: , 2) Course #: , 3) CRN #: ,
3) Local Address: , 4) P/F: , A-F: ,
4) Local Phone: , 5) Term/Year: ,
5) Major: , 6) College: , 6) Credit hours: ,
7) Total Hours Passed: , 7) Date request submitted: ,
8) Overall GPA : , In-major GPA: , 8) Instructor: ,
10) Previously completed hours of 2964, 9) Instructor's number: ,
hours of 4964, hours of 4794 10) Title of Proposed Study (limit of 21 characters):
11) Hours of FS/ST this term: ,
12) Total hours this term: , 11) Related courses already completed by student:
13) Use of this course for:
Free Elective , Other , 12) Does student satisfy departmental standards for
Dept./College Elective Required , 2964, 4964, or 4794?
Yes , No ,
Student must meet the minimum GPA of his/her College and of the department offering the course for approval.
ATTACH DETAILED COURSE SYLLABUS
Give brief description of the study, objective, materials and methods, justification and method of evaluation.
THIS FORM SERVES AS REGISTRATION FOR FS/ST 2964, 4964, AND 4794 COURSES IF PROPER APPROVALS
ARE OBTAINED AND IF THIS FORM IS PROCESSED BY THE STUDENT'S ACADEMIC DEAN.
APPROVALS: (Original to be forwarded to the student's Academic Dean's Office prior to the end of classes of the
Dept. Head of Instructor Date
Academic Dean of Instructor Date
Academic Dean of Student Date