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Grade Reporting Application Form

This document is an application form for a student requesting to have their incomplete grade changed to a final grade. It provides details of the student, their course, school year, term, reason for the incomplete which was due to incomplete quizzes, and a request to have the incomplete grade changed to a final grade of 4.0 units. It requires approval signatures from the professor, dean/chairperson, and registrar.

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Bernardita Quintana
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12 views1 page

Grade Reporting Application Form

This document is an application form for a student requesting to have their incomplete grade changed to a final grade. It provides details of the student, their course, school year, term, reason for the incomplete which was due to incomplete quizzes, and a request to have the incomplete grade changed to a final grade of 4.0 units. It requires approval signatures from the professor, dean/chairperson, and registrar.

Uploaded by

Bernardita Quintana
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

CONTROL NO.

APPLICATION FOR
REPUBLIC OF THE PHILIPPINES
c LATE REPORTING OF GRADE
POLYTECHNIC UNIVERSITY OF THE PHILIPPINES (Please attach certified photocopy of class record)

OFFICE OF THE UNIVERSITY REGISTRAR c COMPLETION OF “INCOMPLETE GRADES”


(Please attach photocopy of Official Receipt)
STUDENT RECORDS OFFICE c CORRECTION OF ENTRY
STA. MESA, MANILA (Please attach certified photocopy of class record)
c OTHERS, SPECIFY: _____________________

Date: 28/02/2021
The Dean
College of: Engineering

I hereby request that

Student Number: 2015-01378-MN-0 Name: Montifar Jerico Lontoc


(Example: 2010-00001-MN-0) (LAST NAME) (FIRST NAME) (MIDDLE NAME)

Course: BSCE Year & Section: III-I


Subject Code: CIEN 3364 Subject Title: Higher Surveying
School Year: 2019-2020 Term: c First Semester
c Day c Second Semester
School Session:
c Night c Summer Campus: Sta. Mesa
which was reported as:
Incomplete(INC)

due to the following reason/s:


Incomplete Quizzes

be credited as one:
c who has “No Grade” in the Grade Sheets to a final grade of units.

c who has completed all requirements with a final grade of 4 units.

c whose name in the Grade Sheet be corrected


From:
(LAST NAME) (FIRST NAME) (MIDDLE NAME)

To:
(LAST NAME) (FIRST NAME) (MIDDLE NAME)

c others , specify:

Thank you.
Engr. Edna Arrojado P.
PROFESSOR/INSTRUCTOR
(SIGNATURE OVER PRINTED NAME)

APPROVED BY DEAN / CHAIRPERSON


Name: Signature: Date:

Received by Office of the Student Records, University Registrar.

Name: Signature: Date:

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