Petition for Incomplete Grade

"*" indicates required fields

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*

First Middle Last

Student Email*

TCC ID*

Course Information*

Class Number

Subject

Catalog Number

Class Section

Semester*

Year*

Instructor's Email*

I am requesting an incomplete grade for the following reason:*

Attach additional pages or documentation

Drop files here or

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.

Signature*

Date*

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Instructor Approval*

Approved

Denied

Indicate whether you approve or deny this request.

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Instructor Denial Reason*

Please provide your reason for denying this request. This reason will be communicated back to the student.

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Default Grade*

Select Default Grade (based on coursework already completed)

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Last Date of Attendance*

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

the student has satisfactorily completed more than 60% of the course requirements and attendance (passed the withdrawal deadline);
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

First Last

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Instructor Signature*

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Instructor Date*