Please fill in the following questionnaire to be eligible to receive
credit for independent study.
- Place a check mark beside the independent study that you are taking.
- TAIS: Computer Science
- TAIS: Desktop Publishing
- TAIS: Multimedia
- TAIS: Video Technologies
- TAIS: Webmastering
- Name_____________________________________
- Phone Number _____________________________________
- Email address _____________________________________
- Grade Level _____________________________________
- School _____________________________________
- Teacher/Mentor _____________________________________
- Guidance Counselor _________________________________
- List the courses that are prerequisites for this Independent Study, the teacher
who taught you each of the classes and the year you completed each.
- Why do you want to take this Independent Study?
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
- What is the general purpose of your Independent Study project?
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
- Have you received a copy of the TAIS: RISD Framework for TEKS-Based Independent Studies
Project and you understand that the Project Resources, Assessment, and Date Completed
columns will be filled in as your project progresses?
Yes _____ No _____
Please sign the following agreement and have a parent or guardian sign also.
AGREEMENT TO COMPLETE TAIS
I understand that I should complete an independent project in a time frame established
with the help of my teacher/mentor. I further understand that I must keep a record of the
project progress and complete the TAIS: RISD Framework. The results of the project will
include my original work synthesized from research conducted with the help of the
teacher/mentor and the peer/discipline review committee. I further understand that I will
be required to publish the results for the community. My grade will be determined by my
teacher/mentor based on the quality and completeness of the project.
Student Signature ____________________________ Date _________
Parent/Guardian Signature _________________________ Date _________
The Technology Applications CED is committed to showcasing Texas
educators but we need your submissions. Please share with other Texas educators what you
and your students are doing. More ideas, activities, and samples of student work are
needed. Submit your resources here
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