DANCE DEPARTMENT INCOMPLETE FORM FOR TECHNIQUE CLASSES

(revised September, 2006)

(Instructor must also complete University form and file with grade sheet.)

The original instructor should complete Part I and have the student sign Part II. The instructor gives one copy to the student and places a copy in the student's file. The student takes his/her copy to the instructor of the course in which classes are being made up. That instructor completes Part III (reverse side) and then gives the form to the original instructor (if still at UNCG); if not, the form goes to the Department Head, who will turn in the removal of Incomplete.
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PART I
Name of student:__________________________________

Social Security # of student: __________________________

Course:  _______(Give all numbers/letters, i.e., 312 A and B-01)

Length of classes (check one):  ___75 minutes ___ 105 minutes ("double" sections)

Semester and year Incomplete received:  _______

Instructor of course in which student received Incomplete: _____________________

Number of classes in which student fully participated: ____
Number of classes student observed:  ____
Number of absences recorded: ____
Student's average grade on work completed thus far: ___
(Unless the instructor indicates otherwise, this grade will be averaged with the grade on the classes made up to determine the final grade.  If the grade for this course should be calculated differently, attach relevant information about how to calculate the grade.)

The student must make up ____ (how many) classes, or the equivalent amount of time in longer/ shorter classes, in order to remove the Incomplete. The classes must be at the ____ level or above.
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PART II:  Student:  Please complete and sign below.
I have read the information above and understand the implications if I do not make up the missed classes on time. I understand that it is my responsibility to contact the instructor of the course in which I will make up the missed classes, as early in the semester as reasonably possible, and present this form in order to secure her/his permission. I will remind that instructor to complete and return this form when I have made up all missed classes.

_____________________________ _______
signature    date

PART III:  To be completed by the instructor of the course in which missed classes are being made up. Return this form to the original instructor or the Department Head.

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instructorπs signature (for permission to take classes) date

The student listed above fully participated in my technique class, DCE ____-__ on the following dates:

These classes were (check one) ___75 minutes ___ 105 minutes ("double" sections).

The student's grade for these classes is ____.

______________________________ _____
signature     date