Registration and Enrollment Services
CONTRACT FOR INCOMPLETE GRADE FOR SPRING 2020 ONLY
STUDENT NAME: _________________________________________ ID: _______________________
COURSE: __________________________________ COURSE TITLE: __________________________
CRN: ____________________ SEMESTER: ___________________ YEAR: ____________________
I hereby request that I be awarded a grade of “I” in the course named above in accordance to policy
303-05 Grading-Procedure amended for Spring 2020. (A copy of the policy is on the back of this
contract.)
______________________________________________________ ____________________________
Student’s Signature Date
TO BE COMPLETED BY THE INSTRUCTOR & THEIR SUPERVISOR
Instructor’s Name: _____________________________________________________________________
Supervisor Name : _____________________________________________________________________
I certify that this student:
Has completed 60% of the enrollment period for this course while maintaining a “C” average for work submitted.
Has presented a case documenting circumstances, which prevented completion of the course requirements.
Entered into the “Contract for Incomplete Grade” with instructor.
Summary of graded activities, % of total grade, and due dates:
Activity % of total grade)
1. _____________________________________________________________________________
2. _____________________________________________________________________________
3. _____________________________________________________________________________
I accept the obligation to initiate a “Change of Grade Form”, upon the student’s submission of specified work, to convert the
grade of “I” to a permanent grade. The GRADE to be assigned if work is not complete___________.
____________________________________________________ _____________________________
Instructor’s Signature Date
___________________________________________________ _____________________________
Supervisor's Signature Date
APPROVED: YES □ NO □
______________________________________________
□ Registrar: ____________________________________
“I” Entered: _______ Final Grade Entered: _________
Due Date
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