Fillable Contract For Incomplete Grade Form - Rollins College printable pdf download

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OLLINS

OLLEGE

AMILTON

OLT

CHOOL

203 East Lyman Avenue, Winter Park, FL 32789

Phone: (407) 646-2232; Fax (407) 646-1551

ONTRACT

NCOMPLETE

RADE

It is the student’s responsibility to submit a completed contract to the Hamilton Holt School prior to the end of term.

Contracts that are not signed by both student and professor will not be honored.

To be completed by the student:

Rollins ID No. ______________________________

Student Name: ___________________________________________________________________________________

TERM: ⁭ Fall ⁭ Spring ⁭ Summer

CRN No: _________ Course Number ___________ Section ____

(Five digit number)

(Ex: ENG 101)

(Ex: H2)

YEAR: ______________________

Course Title: ___________________________________________

Instructor’s Name: _______________________________________

Reason for Incomplete:

______________________________________________________________________________________________

To be completed by the instructor:

In order to remove the incomplete, the following course work must be completed:

______________________________________________________________________________________________

THE DATE BY WHICH COURSE WORK MUST BE COMPLETED: ____________________________________

NOTE TO INSTRUCTOR: The instructor is responsible for submitting a change of grade for the above course within

five days from the deadline date noted, or no later than sixty days from the last date of the semester. A change of

grade form will be forwarded to faculty members if no grade is recorded by the end of the sixty-day period. Faculty

members may assign a grade or approve an extension of up to sixty additional days under extenuating circumstances.

Unresolved incomplete grades will administratively be changed to “F” after the submission deadline.

Student Signature: _______________________________________

Date: ________________________

Instructor Signature: ______________________________________

Date: ________________________

Student distributes copies as follows: COPY 1 - Submit to the Holt School

COPY 2 - Give to the instructor

COPY 3 - Retain for personal record

Last update: 2/21/06

Contract For Incomplete Grade Form - Rollins College