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LUZERNE COUNTY COMMUNITY CO LLEGE (Luzerne County Community College)

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LUZERNE'COUNTY'COMMUNITY'CO LLEGE'
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•!Public!Safety!Training!Institute!•!
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REQUEST'FOR'CHANGE'OF'FINAL'GRADE'
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A!request!for!the!change!of!final!grade!must!be!filled!out!and!signed!by!the!instructor!and!
submitted!to!the!Dean,!Public!Safety!Training.!!Please!note:!No!request!for!final!grade!
change!will!be!permitted!if!more!than!two!(2)!months!have!elapsed!since!the!date!the!
student!was!first!informed!of!his/her!grade!in!the!course.!
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Student’s!Name!!________________________________________________!
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Social!Security!or!Student!ID!Number!_______________________________!
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Course!Name!&!Number__________________________________________!
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Semester!(Spring!or!Fall)________________________!Year_____________!
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I!agree!to!change!the!grade!from!____________!to!____________!
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Reason!for!Change!______________________________________________________________________!
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______________________________________________________________________!
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Date!______________________Instructor’s!Signature!__________________________!
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Approved!by!Dean,!Public!Safety!Training____________________________________!!
!
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Recorded!in!Datatel!on:!______________________________!!
!
!
By!___________________________________________!
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LUZERNE COUNTY COMMUNITY CO LLEGE (Luzerne County Community College)

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Completed 26 July 2020

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