CHANGE OF GRADE	

Date:	______________________

To:	Registrar

From: ______________________________________________________
	Name of Instructor

Please change the grade for the following student:

Name:	________________________________________________________________________________	
		  Last					First					M.I.

Student I.D. # G__________________

Term course was taken:  Fall________	  Spring_______        Summer_________
                                                    Year		       Year                                 Year

CRN #________________	Course Prefix and Number:_______  _______________

Course Title: __________________________________________________________

The grade should be changed from ___ to ___ for the following reason(s):

	Student has made up an incomplete grade. An incomplete must be changed to a final grade within 30 	days after the end of the term in which the grade was assigned or a final grade of “F” will be assigned.

	Error in the grade I submitted to the Registrar’s Office.

	Other: (Please explain):______________________________________________________________

Instructor’s Signature:___________________________________________________

Approval of the Vice President of Academic Affairs is required to change an Incomplete to a W after the last published date to withdraw with a W in a term. Complete documentation must be provided to the Office of the Registrar.

Date change of grade made: ________________		Entered by:_____________