REQUEST FOR GRADE OF INCOMPLETE

Student's Name:______________________________________Student ID:_____________________

Course Number/Section/CRN:_________________________Title:____________________________

Reason for Requesting the Grade of Incomplete:____________________________________________

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Course Requirement(s) to be completed: _________________________________________________

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The assignment(s) will be delivered/mailed to the Instructor on _________________________________
                                                                                                                             ^Date

(No later than FOUR weeks into the following semester).

NOTE:   1) The request must be made in triplicate:  (For the Chairperson, Instructor and Registrar)

               2) Arrangments for the "Incomplete" grade must be made and a copy of
                 this form submitted to the registrar, before the last day of class

   3) The Instructor may assign the "I" grade only to those students who have 
        submitted the request form

   4) The Instructor must submit the final grade (A, A-, B+, B, B-, C+, C, C-, D, F) 
        within FOUR weeks of the following semester