Student Information

First Name *

Last Name *

CSU ID Number * 🛈

Email Address *

Validate Student Email Address *

Major *

Course Information

Course * 🛈

CHEM 384-Supervised College Teaching (1-3 credits)

CHEM 487-Internship (1-6 credits)

CHEM 495-Independent Study (1-3 credits)

CHEM 498-Research* (1-3 credits)

CHEM 499-Senior Thesis (2 credits)

Number of Credits *

Semester *

Fall

Spring

Summer

Academic Year * 🛈

Variable Credit Courses-Credit Hour Policy

The policy described in this section applies to the following courses:

CHEM 384-Supervised College Teaching
CHEM 487-Internship,
CHEM 495-Independent Study, and
CHEM 498-Research
CHEM 499-Senior Thesis

The learning experiences related to the above courses will follow the model of requiring the student to

(Internship) work at the internship’s external site, under the supervision of an approved contact person, or
(Independent Study or Supervised College Teaching) devote focused study or moderate active learning experiences with a faculty member, or
(Research or Thesis) conduct comprehensive research with an active faculty member at Colorado State University with certified laboratory or other facilities where strict chemical safety is observed,

for 3 hours per week, for 15 weeks during the typical semester, to earn one academic credit hour. This translates to an estimated 45 hours of experiential learning per semester for one academic credit hour.

Number of credits registered by the student	Fall or Spring Semester		Summer Session
Number of credits registered by the student	Devoted hours per week	Total hours for the semester (15 weeks)	Devoted hours per week	Total hours for summer session (10 weeks)
1	3	45	4.5	45
2	6	90	9	90
3	9	135	13.5	135
4	12	180	18	180
5	15	225	22.5	225
6	18	270	27	270

The main office will be responsible for retaining the appropriate documentation that corroborates fulfillment of the hour requirements. Students may not be allowed to register for more than 6 credits per academic term.

Approved 5/3/2017 by the Department of Chemistry

I certify that I have read the policies above and that my supervisor and I are responsible for following them *

I certify

Please upload your RCR Certification (applies only for CHEM 498 and 499). If you have not completed the RCR training, please go to https://www.research.colostate.edu/ricro/rcr/online-training-and-certification/ to get your certification.

You do not need to retake the certificate every semester. Just upload your current certificate here.

🛈

Please upload the contact information (full name, phone, email) of your internship supervisor (applies only for CHEM 487) 🛈

Faculty Member Name (or Thesis Supervisor or Internship Supervisor) * 🛈

Department *

Faculty Email Address *

Does the student need to turn in a notebook at the end of the semester? *

Does the student need to turn in an ACS-formatted report at the end of the semester? *

It is mutually agreed upon by the student and the faculty member that they understand the conditions for receiving credit for this course.

Satisfactory completion of this course requires a report written by the student regarding the experience. A hard copy of the report must be submitted to the faculty member by the last day of classes for the semester.

Student Signature *

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