Removal of an Incomplete

This form must be completed and submitted by the Instructor; students are not permitted to turn in their own grades.  For questions please call (307) 766-5272.

All Fields are required.

Student Name:    Student ID#:

Course Title:  

Course Dept and #: Credit Hours:

Term Assigned:  Date Work Completed: 

Date of this Report:  Grade:  

Instructor Name:  Instructor ID#:

I understand the applicable UNIREG and agree to fulfill the conditions established by my instructor for assignment of a grade.  Further I certify that the information I have provided is correct to the best of my knowledge.  If my request is accepted, I agree to abide by the policies, rules and regulations of the University of Wyoming.  I further understand that the information submitted herein will be relied upon by the Officials of the University in determining my request and that the submission of false information is a violation of Federal and State Law. WITHOUT ELECTRONIC SIGNATURE THIS REQUEST WILL NOT BE PROCESSED.

           Select “Yes” for Electronic Signature

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