
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
REQUEST FOR EXTENSION OF “I” CONTRACT
For Completion of Courses in Which
Temporary “I” Has Been Assigned
Do not register for this course again.
This contract extends the I Contract dated _____________ between
the student and instructor listed below. All requirements of the previous I Contract remain as stated in the
contract unless a modification is noted below. Attach a copy of the original “I” contract.
Instructor: Student:
Print Instructor Name Print Student Name
Student Classification Student ID: K00
Course Name/Number & CRN: ____________________________ Semester/Year course was taken:
REASON FOR EXTENSION:
MODIFICATION TO ORIGINIAL “I” CONTRACT:
Course requirements will be completed by:
Date
Signed: _____________________________________________ ______________________________
Student Date
Signed ______________________________________________ ______________________________
Instructor Date
Signed ______________________________________________ ______________________________
Department Chair Date
Signed: ___________________________ ______________
Approved
Disapproved
C
ollege Dean Date
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