1) Student College ID Number
2) Student Name:
LAST FIRST MIDDLE
3) Semester: Fall Winter Spring Summer
Year:
2 0
_________
4)
5) Description of work to be completed
6) Date student work to be completed by (not to exceed one year)
Format=mm/dd/yyyy
7) If work is not completed, letter grade to be assigned: ___________ Units: _____________
Our signatures below indicate that we are in agreement to the above-described information and terms.
8)
Student's Signature Date
9)
Instructor's Signature Date
Print Name: Contact Phone #:
A&R Office Use only: Grade Change form received Date Processed:
Distribution: Original - A&R Incomplete Grade Report - 03/12/2012
ellow - Instructor
Pink - Student
Section # Course Name & Number Course Description Instructor
Instructions:
This form is a contract between the instructor and the student and must be signed by both. An Incomplete (I) grade may
only be awarded for incomplete academic work due to an unforeseeable emergency or justifiable reason near the end of the term.
Before
issuing an incomplete grade, the instructor and student should agree on the work the student needs to complete in order for the instructor to issue
the student a valid letter grade. By completing and signing this form, the student and instructor should have a clear understanding of how to
reconcile an incomplete grade and the consequences for not reconciling grades in a timely manner.
Student Reconciling an Incomplete (I) grade: There are three ways to reconcile an Incomplete (I) grade:.
Instructor Reconciling an Incomplete (I) grade: If you have questions, please contact the Records staff at x5020.
(1) Contact your instructor and make up the necessary work to earn a final grade.
(2) Do nothing for an entire academic year and your default grade will be automatically posted. This option prevents you
from enrolling formally in the same course until the default grade is posted one year later.
(3) Ask that your instructor give you the default grade of an F, D, or NP instead of an "I" so that you may immediately
retake the course.
Remember that you are blocked from repeating the same course if you have not reconciled an
incomplete grade and you may not "sit in" the class without being registered.
(1) If the student completes the work to your satisfaction by the pre-determined date or within one-year, whichever comes
first, you must complete a Academic Records Change Form (
Grade Change Form
)and submit it to the Records Office.
(2) If the student never completes the work within the time period agreed, do nothing. The default grade will be assigned
by the Records Office using the completed information below. The default grade may be an F, NP, or a grade that reflects
the work that was satisfactorily completed without the incomplete work.
(3) Give the student a default grade of an F, D, or NP instead of an "I" so that the student may immediately retake the
course.
You may not allow the student to "sit in" a class without the student being registered.
click to sign
signature
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click to sign
signature
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