Instructor's Change of Grade Request Form

Faculty may request to change a grade only if an error in grade calculation or recording was made or if an Incomplete was granted. No change of grade can be made after a diploma or diploma supplement is issued.

Student's name Student's name First Last
Change of grade request for
(semester)
(Year)
Course number
Course title
Change of percentage FROM
Change a grade FROM
(calculated automatically)
Change of percentage TO
Change a grade TO
(calculated automatically)
Reason for grade change
Name (acts as your digital signature) Name (acts as your digital signature) First Last
Date Date / MM / DD YYYY