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Petition for Incomplete Grade

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This form is for students requesting an Incomplete Grade. Please note that submission does not guarantee approval. Students who have verifiable and unavoidable circumstances preventing them from completing a course within the normal timeframe may use this form to request an incomplete grade (“I” grade) from their course instructor. Eligibility requires that the student has satisfactorily completed more than 60% of the course requirements and attendance, as well as passed the course withdrawal deadline.

Form must be processed prior to the last day of instruction for the course.

Student Name*
Course Information*
Class Number
Subject
Catalog Number
Class Section
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Max. file size: 32 MB.

    Please list the outstanding work/assignments needed to complete the course/ Note: completion due date may not be set beyond the last day of instruction for the subsequent semester(without written approval of the Pathway Dean)

    Outstanding work/assignments*
    Assignment Name
    Course Weight (%)
    Due Date
     

    STUDENT: By signing below, I agree to complete the work/assignments detailed above before the due date. If I do not, I understand my currently assigned course grade will remain on my permanent academic record.

    Clear Signature
    MM slash DD slash YYYY
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    Instructor Approval*
    Indicate whether you approve or deny this request.
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    Default Grade*
    Select Default Grade (based on coursework already completed)

    Please note that before completing this form, you should have already entered the “I” grade in SIS. By approving and signing below, I acknowledge:

    1. the student has satisfactorily completed more than 60% of the course requirements and attendance (passed the withdrawal deadline);
    2. prior to the end of the subsequent semester, once work/assignments have been completed, I will submit a Grade Change Form reflecting the final grade for the student
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    Instructor Name
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    Clear Signature
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    Select date MM slash DD slash YYYY