Registrar 5/2/16
OFFICE OF THE REGISTRAR
MSC 105, 1050 W SANTA GERTRUDIS AVE
KINGSVILLE, TEXAS 78363-8202
PH (361) 593-2811 * FAX (361) 593-2195
www.tamuk.edu
CONTRACT BETWEEN INSTRUCTOR & STUDENT FOR COMPLETION
OF A COURSE IN WHICH A TEMPORARY “I” HAS BEEN ASSIGNED
(To be Submitted When Grades are Due)
STUDENT SECTION (DO NOT REGISTER AGAIN FOR THE COURSE BELOW)
Name:___________________________________ Student ID #: K00_________ Classification ___________
(Print Name of Student)
I agree to complete _____________________ ___________ of ____________________ by submitting the
(Course & Course Number) (CRN #) Semester
Required Course requirements, which are listed in the faculty section, to the instructor.
The requirements, as noted below, will be completed by ___________________(date) and will not exceed 12 months from the date the
“I” is awarded. I understand that if I do not fulfill conditions of the above agreement, my instructor will change the “I” to “F”. The
student is required to verify that the Office of the Registrar has replaced the “I” with an appropriate letter grade
approximately 30 days after completion of work.
STUDENT Signature: __________________________________________ Date: ______________________
FACULTY SECTION (This contract is valid without the signature of the student.)
REASON FOR I: __________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Description of course requirements to be completed by the student: ___________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
It is the responsibility of the instructor to initiate an appropriate grade change in a timely manner upon completion of the contract
agreement. The faculty member will submit the completed form even though the student is unavailable to sign this document.
INSTRUCTOR Signature: ______________________ Date:___________
DEPARTMENT CHAIR: ______________________ Date: ___________
COLLEGE DEAN: ___________________________ Date: ___________ Approved Disapproved
Copies (to be distributed by the Instructor/College):
1 copy to student
1 copy to instructor
1 copy to department chair
1 copy to Dean of appropriate college 1 copy to Graduate
Dean for Graduate Students
