For your convenience, you may fill out this form and print it. This agreement should be retained by faculty and student to confirm the approval and conditions for the Incomplete grade. Do not send to UMUC headquarters unless requested.
Student Name:
Address:
Student ID Number:
Course Number:
Section Number:
Course Name:
Semester:
Select Spring Summer Fall Year: Select 2013 2012 2011 2010
The above named student is eligible to receive the mark of I (incomplete) for the course specified. The I will be converted to a letter grade upon completion of the following requirements:
The course requirements must be completed by: (Not more than four months from the end of the course.)
If the course requirements are NOT completed as scheduled, the I will be converted to the following letter grade. Please Note: If a letter grade is not specified, the I will become an F if the course requirements are not completed as scheduled.
This change was requested by the student on
Faculty Signature: _____________________________ Date: ___________________
Faculty name (Please Print): ______________________________________________