Tennessee State University
Records Office, Floyd-Payne Campus Center, Suite 305
“I” GRADE REPLACEMENT FORM
(Please print.)
NAME _________________________________________
Last
First
Semester:
T Number: T_____________
M.I.
Fall 20____
Spring 20____
Dis.
Course No.
Course Title
(e.g. ENGL)
(e.g. 1010)
(e.g. FRESHMAN ENGLISH I)
Summer 20____
Hrs.
New Grade
________________________________________
________________________________________
Instructor’s Signature
Department Head’s Signature
Date
Received by_______________________
Date Issued_____________
Date