DCPS Grade Change Form

DCPS Grade Change Form
1. To initiate a grade change, this form should be completed by the individual requesting the change (teacher, principal, or school counselor).
2. All required sections of this form must be completed.
3. Upon approval, the school counselor should print the email (grade change form)and approval form. Both documents should be placed in the students’ cumulative file.
First and Last Name of the Staff Person Requesting the Grade Change*

First NameLast Name
Your Email*
example@example.com
Email of School Counselor (Double Check email address for Accuracy)*
example@example.com
Email of School Principal (Double Check email address for Accuracy)*
example@example.com
Student's First and Last Name*

First NameLast Name
Student's ID Number*
School*

Cambridge South Dorchester High SchoolNorth Dorchester High SchoolDorchester Career and Technology CenterMaces Lane Middle SchoolNorth Dorchester Middle SchoolSouth Dorchester PK-8Choptank Elementary SchoolHurlock Elementary SchoolMaple Elementary SchoolSandy Hill Elementary SchoolVienna Elementary SchoolWarwick Elementary School
School Year*

2022-20232023-20242024-20252025-2026
Student Grade Level at the Time the Original Grade Was Assigned:*

121110987654321KPK
Course Name*
Class Period (Secondary Only) Elementary enter NA*
Teacher Name For the Course with the Grade Change*
Grading Period for Grade Change*

Quarter 1Quarter 2Quarter 3Option 4Final Grade
Original Letter Grade*

ABCDEN/AOther
Original Percentage Grade*
New Letter Grade*

ABCDEN/AOther
New Percentage Grade*
If you do not know, enter 0.0
Reason For Grade Change Request*
Should be Empty: