Name: _________________________ Net ID: _________________________ UIN: _________________________

Major: _________________________ College: _______________ Graduation Date: ________________

Year: Freshman (1st yr.) Sophomore (2nd yr.) Junior (3rd yr.) Senior (4th yr.)

TO BE COMPLETED BY THE ECONOMICS OFFICE:

Course Section: ____________________ Course CRN: ____________________

Use the following space or submit an attachment with the description of the paper/project being done for this independent study. Be as specific as possible, including title, purpose of study, length, timeline, etc.

Economics 199 Independent Study or Research Assistant

Economics 199 Teaching Assistant

Economics 399 Independent Study or Research Assistant (Must be of Junior or Senior standing and have completed ECON 302.)

Yes No

Do you intend to use Econ 399 as part of the criteria to graduate with Distinction in the Dept of Economics? http://economics.illinois.edu/undergrad/students/distinction/

Unsure at this time

Form Approved

Override Completed

Student’s Signature: _________________________________________________________ Date: _______________

Instructor’s Signature: ________________________________________________________ Date: _______________

Credit Hours: __________ Grading: Letter Grade (available in 1-9 credit hours)

Satisfactory/Unsatisfactory (available 0-9 credit hours)

Instructor's Name (Print): _____________________________________________________ Date: _______________

Semester/Year Taking Course: _____________________