Fillable OFFICE OF THE UNIVERSITY REGISTRAR Mailing Address: P.O. (MacEwan University)

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OFFICE OF THE UNIVERSITY REGISTRAR Mailing Address: P.O. (MacEwan University)

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Country of origin: CANADA
File type: PDF

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PERSONAL INFORMATION COLLECTION NOTICE
The personal information requested on this form is collected under Section.33(c) of the Freedom of Information and Protection of Privacy Act for the purpose of one or all
of the following: to determine eligibility for admission and financial assistance, to advise students about academic programs and to provide university services at MacEwan
University. Questions concerning this collection should be directed to the Lead, Privacy and Information Management at privacy@macewan.ca
OFFICE OF THE UNIVERSITY REGISTRAR
Mailing Address: P.O. Box 1796 • Edmonton, Alberta, Canada T5J 2P2
Phone: 780-497-5000 • Toll Free: 1-888-497-4622
Website: www.MacEwan.ca • E-mail: info@macewan.ca
EXTENSION OF AN INCOMPLETE GRADE FORM
NOTE: ($50 FEE PER COURSE)
STUDENT ID NO.: TERM: FALL WINTER SPRING SUMMER
YEAR:
PROGRAM: FAMILY (LAST) NAME: FIRST NAME: MIDDLE NAME:
COURSE NUMBER: SECTION NUMBER: COURSE TITLE:
COMPLETION OF COURSE IF COURSE WORK IS NOT COMPLETED BY THIS DATE,
WORK EXTENDED TO: ___________________________________________________________ THE REGISTRAR SHALL RECORD A GRADE OF: ________________________________________________
___________________________________________ _______________________________________________ _______________________________________________
STUDENT’S SIGNATURE INSTRUCTOR’S SIGNATURE PROGRAM DIRECTOR’S SIGNATURE
___________________________________________ _______________________________________________ _______________________________________________
DATE DATE DATE
PAYMENT METHOD
DEBIT CHEQUE
OFFICE USE ONLY
FEES ENCLOSED: _______________________________________________ PURGED NO.: ___________________________________________________
ENTERED BY: ___________________________________________________ DATE: __________________________________________________________
CASHIERS INITIALS: _____________________________________________ DATE: __________________________________________________________
RECEIPT #: _________________________________________________________________________________________________________________________
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OFFICE OF THE UNIVERSITY REGISTRAR Mailing Address: P.O. (MacEwan University)

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Completed 30 January 2021

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