Peru State College Graduate - Action Research/Thesis Permit to Register

This form is to be completed by a Graduate student seeking an Action Research/Thesis Project I & II.

Date Date / MM / DD YYYY
Student Name Student Name * First Last
Student Phone Student Phone * - ### - ### ####
Student Email *
PSC Academic Program *

PSC Academic Program M.S. Education - Curriculum & Instruction M.S. Organizational Management
Year to enroll in graduate Action Research Project/Thesis *
Semester to enroll in graduate Action Research/Thesis *

Semester to enroll in graduate Action Research/Thesis Fall Spring Summer
Credit hours you wish to complete within the semester above of graduate Action Research Project OR Thesis? *

Credit hours you wish to complete within the semester above of graduate Action Research Project OR Thesis? 3 credits - Action Project I OR Thesis I 3 credits - Action Project II OR Thesis II 6 credits - Action Project I/II OR Thesis I/II
Requesting Faculty Mentor *

Faculty Mentor within your program of study.
Please check the box next to each item to indicate your understanding of the item. *

Please check the box next to each item to indicate your understanding of the item. I have read the Graduate Action Research Project Guidelines and agree to comply with said requirements, https://graduate.peru.edu/_documents/21Guidelines_for_Completing_an_Action_Research_Project.pdf I have discussed this Action Research Project/Thesis opportunity with the Graduate Programs Office/chosen Faculty Mentor regarding the topic of this chosen research. (This form is routed to your advisor for their approval).
I have previously enrolled for Action Research/Thesis. *

I have previously enrolled for Action Research/Thesis. Yes No
I have completed or will also be enrolled for EDUC/MGMT 601 or EDUC/MGMT 602. *

I have completed or will also be enrolled for EDUC/MGMT 601 or EDUC/MGMT 602. Yes No
Offer a proposed title of this Action Research Project/Thesis and a detailed description of what is to be to covered. *
By submitting this form, I understand that this approval is for the above described project only. Any changes to the above described project must be approved in advance. It is the responsibility of the graduate student to meet the requirements for the Graduate Program Action Research Project/Thesis in a timely manner and within the semester enrolled. Failure to do so may result in termination of the graduate thesis/action research project or assignment of grade of “F”.
Student signature
Draw your signature into the box below. *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.