Incomplete Grade Form
(To be completed by Student)
Student Name _____________________________________________ myWSU ID# _____________________
Course: SCWK _______________ CRN # ________________ Semester _____________ Year: 20 _______
Instructor Last Date of Attendance/Participation _______________
1. Briefly provide a rationale for your request for the incomplete.
2. List/describe the work that needs to be completed for the course requirements.
I understand that instructors do not automatically grant nor are they obligated to give an incomplete in a course.
There must be extenuating circumstances that lead to the decision to request an incomplete and the opportunity
to complete this course. It is my responsibility as the student to ensure that I complete all course work in
agreement with the instructor.
I understand that I will not be able to progress into the practicum until the incomplete grade is resolved.
BSW ONLY: I understand that, according to university policy as stated in the WSU Undergraduate Catalog, the
incomplete will automatically be changed to an “F” if I have not completed the course requirements by the end
of the next semester in which I enroll (excluding the summer term).
MSW ONLY: I understand that, according to the Graduate School policy as stated in the WSU Graduate
Catalog, if I have not completed the course requirements by the end of the second semester following the
assignment of the incomplete (excluding the summer term), I will have to retake the course to receive credit.
Student’s signature _______________________________________ Date __________________________
Instructor’s Approval
(To be completed by instructor)
Current grade in the course _____________ Final grade if missing work is not completed ______________
Coursework to be completed by this date _____________________
Instructor’s signature ______________________________________ Date __________________________
Rev 07/12
