2006-07 College Catalog - South Florida State College

SOUTH FLORIDA COMMUNITY COLLEGEAVON PARK, FLORIDA 33825-9399INCOMPLETE GRADE REPORTAll DepartmentsPART 1: This form MUST be completed for EACH student receiving an “I” grade per course and disbursed accordingly.Instructor is responsible for giving student a copy of this form.Student Name:_____________________________________Social Security Number:________________SFCC Student ID Number:_________________Course CRN:_______________Prefix:__________Number:__________Date to be completed AND returned to Records Dept.:______________________________________(Within 6 weeks)Reason for granting the “I” grade:___________________________________________________________________________________________________________________________________________________________________________________________________________________________________Requirements for removing an “I” grade:_________________________________________________________________________________________________________________________________________Grade to be assigned if requirements are NOT met:_________________________________________Instructor’s Signature:___________________________________________Date Issued:______________PART 2 Return instructor copy to Records Office when work is completed.Work has been completed. Student is hereby assigned a grade of:________________________________Instructor’s Signature:__________________________________________Date:____________________PART 3 Request for extension of incomplete.Reason for requesting extension:_______________________________________________________________________________________________________________________________________________Date to be completed (6 weeks):___________Instructor’s Signature:______________________________Approval_____Disapproval_____Department Chair’s Signature:_________________________________NOTE: If there is to be an extension granted, the Records Department MUST be notified with acopy of this form.Doc. TypeREC - 4