Student Name:_______________________________________ Date: __________________ARE YOU ON ACADEMIC PROBATION? Yes _____ No _____
(please print)
Address: _______________________________________ Soc.Sec.No.: __________________
_______________________________________
_______________________________________
e-mail: ______________________________________ Telephone: (____) ____ - _______
Term desired: (NOTE: A NEW FORM must be completed for EACH term)
Fall ________ Spring ________ Summer ___________ Year _______
Credits sought: Dept ________ Tech ________ General Elective ________
Maximum number of credits one can earn for special problems is a total
of six -- at the most, three in any semester.
Undergraduate (B.S. candidate), your year: _________ GPA ______
Name of professor supervising your work: __________________________________________
(please print)
If he/she is outside the ECE department, his/her department: __________________________________________
(please print)
Co-advisor (required with 'outside' advisor,
must be a faculty member in ECE): __________________________________________
(please print)
Approval Signature(s) of Supervising Professor(s): [PLEASE SEE BELOW]
____________________________________ ___________________________________
NOTE TO ADVISOR(S): Please make sure that the student submits a
one-page description of the
proposed work and its relevance to Electrical and Computer Engineering
IMPORTANT INFORMATION FOR YOU (THE STUDENT):
1. AFTER THIS FORM HAS BEEN COMPLETED, with all required signatures,
it must be submitted to Professor P. Sannuti (CORE-Rm 525). Failure to do so
could result in deletion from the grade roster or receipt of a failing grade.
2. UNDERGRADUATES must submit a formal report of their work to their project
supervisor at the end of the semester, with a copy going to the ECE
Undergraduate Director, Dr. P. Sannuti.
Signature of Student:__________ ________________________________