1. CONTRACTUAL AGREEMENT FOR ISSUANCE OF “INCOMPLETE”



CONTRACTUAL AGREEMENT FOR ISSUANCE OF “INCOMPLETE”
 

               
           
LAST NAME       FIRST NAME       MIDDLE NAME  LOLA STUDENT ID #
           

                 
 
COURSE TITLE      COURSE NO./SECTION  CRN NO.   SEMESTER/YEAR    INSTRUCTOR
 
 
It is agreed that the following assignment must be completed on or before       DATE


         SEMESTER in order to remove the “I” received for the above-listed course.
 
I understand that an “I” will be placed on my transcript until I complete the aforementioned assignment. If I do not complete the assignment by the date listed above, I understand that the “I” will convert to an “F”.
 
ASSIGNMENT:


 
 
It is understood that completing the contracted assignment will not guarantee a passing grade. My grade will be based on the quality of work as well as the completion of the assignment by the date stated.
 
____________________ ________    ____________________ __________
Student’s Signature     Date     Instructor’s Signature   Date
 
 
APPROVED:
 
 
Division Dean            Date
 
 
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
 
Extension granted until________________   _____________________
  Date                         Semester
 
________________________ _____________ __________________________  ________
Instructor     Date Division Dean    Date
 
 
Office of the Registrar's Staff:

________________________ _____________
Processed by:     Date

 


Form 1441/001 (10/2020)

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