A copy of this form is to be maintained by the student, the instructor, and the department office
Incomplete Grade Documentation Form
Students are required to complete all courses for which they are registered by the end of the semester. In some cases, a
student may be unable to complete all of the coursework because of extenuating circumstances.
The student may petition the instructor for time beyond the end of the semester to finish the work. If the instructor agrees,
two grades will be given, an "I" and a letter grade for the course computed as if the missing work were zero (IA, IB+, etc.).
This form must be filed by the instructor in the department or college office.
The student is required to complete the work by the time agreed upon (which may not be longer than 12 months).
If no change of grade is submitted by the instructor within the prescribed period, the "I" will be removed and the letter
grade originally submitted with the "I" will remain as the permanent grade for the course.
An incomplete grade may be granted only if the student has completed the majority of the course and is passing the class at
the time.
The full policy is found at http://catalog.usu.edu/content.php?catoid=12&navoid=3805. Faculty and students are expected
to familiarize themselves with the full policy.
After discussing the incomplete option with the instructor, the student completes the Student Section and signs this form.
The student DOES NOT re-register for the course.
Student Name: _______________________________________
A-Number: __________________________________________
Email Address: _______________________________________
Semester & Year
CRN (5 digits)
Course # (4 digits)
Section (3 digits)
Instructor Name
Reason for Granting Incomplete:
Coursework to be Completed:
Deadline for Completion of Work (Month / Day / Year): __________ /_________ /_____________
STUDENT SIGNATURE:____________________________________ DATE: ___________________________
INSTRUCTOR SIGNATURE: _________________________________ DATE: ___________________________