ASSIGNMENT OF “I” (INCOMPLETE) GRADE
SEMESTER: YEAR: COURSE:
Title Course Identifier Number (CRN)
You have been assigned an “I” (Incomplete) grade for meeting the Title 5 CCR 55023 unforeseeable emergency
and justifiable reason. The conditions for removal of this “I” grade are:
If you do not complete the above work, your grade will become an .
INSTRUCTOR’S PRINTED NAME DATE
INSTRUCTOR’S SIGNATURE DATE
DEADLINE FOR COMPLETION: The “I” may be made up no later than one semester following the end of
the term in which it was assigned unless instructor has designated a different completion date.
I have discussed this form with the instructor and have received a copy.
STUDENT’S PRINTED NAME DATE
STUDENT’S SIGNATURE DATE
INSTRUCTOR FOLLOW-UP
(If no follow-up by instructor, the grade will default to grade indicated above.)
WORK COMPLETED: YES NO CHANGE GRADE TO:
INSTRUCTOR’S SIGNATURE DATE
Revised 05/04/2020 TP
Student Name (Please Print)
Student ID
Record’s Office Only: Date “I” Grade Entered: ______________ Entered by: ________________________
Record’s Office Only: Date “I” Grade Updated: ______________ Updated by: _______________________
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click to sign
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signature
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