Grade Change Request *Teacher fills out the grade change request form. * Admin receives the form to review in an email. *Admin will reply to the email with approval. * PEIMS Clerk will receive the admin email and correct the grade. Student Name(Required) First Last Student ID(Required) Grade Level(Required)Select Grade level1st2nd3rd4th5th6th7th8th9th10th11th12thCampus(Required)Select your campusJubilee San AntonioJubilee Highland HillsJubilee Lake View University PrepJubilee Highland ParkJubilee KingsvilleJubilee LivingwayJubilee HarlingenJubilee Wells BranchJubilee BrownsvilleJubilee Leadership AcademyJubilee WestwoodJubilee SenderoTeacher Name(Required) First Last Teacher ID(Required) What area will the grade change be indicated?(Required) Cycle Semester Select the cycle that apply(Required) 1st 2nd 3rd 4th 5th 6th What school year is this change for?(Required)Select the semester that apply(Required) Semester 1 Semester 2 Cycle 1Course Name(Required) Course Number(Required) Section(Required) Current Average(Required)Select the average you would like to correct. Blank Incomplete(I) N/G Cycle grade New Average(Required)Enter the new average. Reason(Required) Replacing a missing grade Teacher Error correction Make-up work Explain the reason(Required)Cycle 2Course Name(Required) Course Number(Required) Section(Required) Current Average(Required)Select the average you would like to correct. Blank Incomplete(I) N/G Cycle grade New Average(Required)Enter the new average. Reason(Required) Replacing a missing grade Teacher Error correction Make-up work Explain the reason(Required)Cycle 3Course Name(Required) Course Number(Required) Section(Required) Current Average(Required)Select the average you would like to correct. Blank Incomplete(I) N/G Cycle grade New Average(Required)Enter the new average. Reason(Required) Replacing a missing grade Teacher Error correction Make-up work Explain the reason(Required)Cycle 4Course Name(Required) Course Number(Required) Section(Required) Current Average(Required)Select the average you would like to correct. Blank Incomplete(I) N/G Cycle grade New Average(Required)Enter the new average. Reason(Required) Replacing a missing grade Teacher Error correction Make-up work Explain the reason(Required)Cycle 5Course Name(Required) Course Number(Required) Section(Required) Current Average(Required)Select the average you would like to correct. Blank Incomplete(I) N/G Cycle grade New Average(Required)Enter the new average. Reason(Required) Replacing a missing grade Teacher Error correction Make-up work Explain the reason(Required)Cycle 6Course Name(Required) Course Number(Required) Section(Required) Current Average(Required)Select the average you would like to correct. Blank Incomplete(I) N/G Cycle grade New Average(Required)Enter the new average. Reason(Required) Replacing a missing grade Teacher Error correction Make-up work Explain the reason(Required)Semester 1Course Name(Required) Course Number(Required) Section(Required) Current Average(Required)Select the average you would like to correct. Blank Incomplete(I) N/G Cycle grade New Average(Required)Enter the new average. Reason(Required) Replacing a missing grade Teacher Error correction Make-up work Explain the reason(Required)Semester 2Course Name(Required) Course Number(Required) Course ID(Required) Current Average(Required)Select the average you would like to correct. Blank Incomplete(I) N/G Cycle grade New Average(Required)Enter the new average. Reason(Required) Replacing a missing grade Teacher Error correction Make-up work Explain the reason(Required)HiddenSection BreakSubmitter Name(Required) First Last Submitter Signature (Draw you Signature)(Required)Submitter Email(Required) Date(Required) MM slash DD slash YYYY Δ