Student Name: ___________________________________ ID # _________________
Course Number and Title: _______________________________________________________________
Semester/Term: _______________________
Reason for incomplete:
Incomplete grades should only be given in the event of illness or extenuating circumstances and will only be approved if sufficient
justification is provided.
Course requirement (s) to be completed:
Anticipated date of completion
The deadline for submission of grades is the end of the sixth week of the next regular—fall or spring—semester. If more than one
requirement needs to be fulfilled, a schedule of completion dates could be helpful.
Grade to be entered if no further work is submitted: __________
If a grade is not submitted prior to the established deadline, the I automatically becomes either an F or the grade submitted above.
_____________________________________________ ____________
Instructor Date
_____________________________________________ ____________
Student Date
(Student’s signature, indicating concurrence, should be obtained if
Received by Registrar ______________ ________
(Initials) Date
Copy to: ____ Instructor
____ Student