Request for Incomplete

I hereby request that:
be awarded a grade of "I" for the year, semester and course indicated:

I certify that the student has been informed of the terms of this incomplete grade. The student is aware that he/she must complete the requirements for this course by the date indicated below or a grade of "F" will be recorded on his/her official transcript.

Any extension of time beyond this date (thirty calendar days into the next semester) must be approved by the instructor and the Vice President of Instructional Affairs.
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