Assignment of an Incomplete

Name of Student ____________________________________________
Student Banner ID Number @ _________________________________
Name of Faculty Member _____________________________________
Course Number/Section ______________________________________

Policy

An Incomplete (I) is a temporary grade assigned to a student who, because of special circumstances, cannot complete the requirements of a course within the regular semester, and who has received a written time extension from the faculty member. The course work must be completed by the end of the tenth week of the next standard semester, and the Incomplete converted to a letter grade, or it automatically converts to the grade of _____ (faculty member must indicate).
(Note: the Registrar will assume that a default grade is “F” if no other grade is indicated.)

Requirements

In order to complete the course requirements, the student must (attach additional pages if needed):
(Optional) The student has already completed the following assignments and tests and earned the following grades:

Faculty Member’s Signature _________________________________ Date _____________
Student’s Signature ________________________________________ Date _____________
Division Director’s Signature _________________________________ Date _____________

Faculty Member retains original signed copy.
Copies: Student, Division Director, Academic Dean, Registrar, Faculty Member retains original signed copy