Incomplete ("I") Grade Form : Department of Physics : Texas State University

This form should be completed and submitted by the instructor. The instructor should consult with the student on the content of the form, if possible. Students are not permitted to submit this form.

Student first name *

Student middle initial

Student last name *

Student ID # (e.g., A01234567) *

Student TXST email address (e.g., x_y123@txstate.edu) (Note: The completed form will be sent to this email address.) *

Course # (PHYS ____) *

Course section #

Semester taken *

Year *

Instructor last name (and first initial, if necessary)

Instructor TXST email address (e.g., ab12@txstate.edu) (Note: The completed form will be sent to this email address.) *

Reason for Incomplete Grade *

What percentage of the required coursework has the student completed? *

What is the grade average of the completed work? *

Indicate in this space what work the student must complete for the "I" grade to be removed. *

Date by which the instructor requires that the work be completed *

If the requirements are not met by the deadline, what grade will the instructor assign? *

The following checkbox is equivalent to the instructor's signature. (required) *

I, the instructor, acknowledge and agree to the terms in this form.

The following checkbox is equivalent to the student's signature. (preferred, but optional)

I, the student, acknowledge and agree to the terms in this form.