Report for Incomplete Grade "I" Form

308 McLAUGHLIN HALL                          STUDENT AFFAIRS OFFICE 
COLLEGE OF ENGINEERING                       UNIVERSITY OF CALIFORNIA


                      REPORT ON GRADE "I" (INCOMPLETE)

Student's Name:__________________________Course________ Semester_________

Reason for grade "I":____________________________________________________

_________________________________________________________________________

Grade for work completed:________________________________________________

_________________________________________________________________________

Requirements for removal of grade "I":___________________________________

_________________________________________________________________________

_________________________________________________________________________

Percentage of grade to be derived from work to be completed:_____________

Suggested date by which work is be be completed:_________________________

In the event of my absence the student should consult:___________________

                      _____________________________  ____________________
                               Instructor                 Date



In addition to the copy of this report submitted to the department
chairman, a report on grade "I" in UNDERGRADUATE courses must be
sent to 308 McLaughlin.  For GRADUATE STUDENTS  the report should
be placed in the department's graduate student files.