Agreement for Completion of Course Work
A student may be eligible to request an Agreement for Completion of Coursework from an instructor if it is determined that: 1)
the student is doing satisfactory work; and 2) the student is unable to complete the coursework within the academic term due to
an illness or emergency. Incomplete coursework is due prior to the end of the next term. An “I” grade will temporarily be
recorded on the student’s transcript to indicate incomplete coursework. Click here to view the incomplete grading policy.
Student Name: ________________________________________________________ Z #: ___________________________
Student Phone: (________) __________- ___________________
Subject/Course/Section: ____ ____ ____ ____ - ____ ____ ____ ____ - ____ ____ ____ CRN #: _________________________
Course Title: ____________________________________________________________ Term Course Offered: _____________
Instructor’s Name: _______________________________________________________ School: _________________________
Reason for Incomplete: ____________________________________________________________________________________
This is a: _____ New Agreement _____Extension of Existing Agreement Due Date: _______________________
Note: Remaining coursework must be completed and submitted before the due date noted above, but before the last day of
class in the next term as noted on the academic calendar
. Once the coursework is complete, the instructor will submit the final
grade to the Registrar’s Office within (7) calendar days. If the grade is not submitted by the grading deadline for the term, the
“I” grade will automatically be changed to an F or NC, as appropriate.
Summary of Coursework Currently Completed:
% of Total Grade Including Currently Completed Coursework: _____% Grade Based on Current Coursework: ______
Summary of Remaining Coursework:
Special arrangements for {the timing of the} completion of courses such as lab courses, foreign language courses, or internships
must be described in an attachment and approved by the appropriate Dean(s).
Student Signature: _____________________________________________________________ Date: __________________
Instructor Signature: _____________________________________________________________ Date: __________________
Dean Signature: _____________________________________________________________ Date: __________________
(Dean signs to acknowledge receipt only)
Signed copies of this form will be provided to the student, the instructor, and the Dean, who will retain a file copy of the
form. Any addenda regarding special timing for completion of work to be done must be signed by all 3 persons above, with
the Dean signing as approving those circumstances and the timing exception.