Webster University - Little Rock Metro
200 West Capitol Avenue
Suite 1500
Little Rock, AR, 72201, USA

Phone: 800-828-2598
or 501-375-1511
Fax: 501-375-1623


Please provide the following information:

First Name:

Last Name:

Address:

City:

State:

Zip:

Email:

Student No:

    

 

Work Ph:

    

Home Ph:

Dep't & Course No:

Term:

Spring 1 (Jan-Mar)

Spring 2 (Mar-May)

Summer (May-Jul)

Fall 1 (Aug-Oct)

Fall 2 (Oct-Dec)


Pay options: (pick all that apply)

FA = Financial Aid
ER = Employer Reimbursement
PD = Paid
DB = Direct Billing
 



VA = Veteran's Administration
VR = Vocational Rehab
TA = Tuition Assistance
TR = Tuition Remission

Please explain your reason for needing the above course as Directed Study:
(please limit your explanation to approx. 150 words.)

• Students may take no more than 2 Directed Studies during their graduate program.
• Requests must be made for the term in which the campus is currently registering.
• Directed studies will NOT be granted for requests received after the registration period.
• Requests are subject to approval by the Director, the Office of Academic Affairs, and the Instructor. (Requests are not guaranteed.)
• Directed Studies will not be granted for electives.
• Upon receipt of your approved directed studies syllabus, it is your responsibility to contact their instructor regarding their lessons.
• For additional information check the Webster University Graduate Studies Catalog or visit our website at www.webster.edu/littlerock.

Student signature: (printing your full name will be accepted in lieu of a signature and constitute your desire to submit this form to request a directed study).