Deferment of Admission Request Form

O FFICE OF G RADUATE A DMISSIONS

4202 East Fowler Avenue, SVC 1036, Tampa, Florida 33620
TEL: (813) 974-3350 FAX: (813) 974-9689
www.usf.edu/admissions

INSTRUCTIONS: Although you have already been admitted, deferring your admission to another term does not guarantee future
admission. You must obtain permission from the program. This request must be submitted directly to the graduate program and
must be processed within 12 months of the original admission and before the program's application deadline to the new term. For
program locations, go online to: http://www.grad.usf.edu/programs_college.php. Please fill out the Personal Information, New Term
of Entry and Graduate Program sections completely; failure to do so will delay the processing of your request.
International Students Only:
International students must also provide a new Financial Statement and Promissory Note of Financial Support dated less than 12
months prior to the desired term of entry. Please refer to the International Services website for further information:
http://global.usf.edu/is/pro-financialdocs.php

University ID#:

Legal Name:
Last Name First Name Middle Name

Street Address Apartment Number

City / State / Zip Code

Telephone Number (please include area code) Fax Number (please include area code) E-mail Address

X
Signature of Student Requesting Deferment Date

NEW TERM OF ENTRY GRADUATE PROGRAM

Insert Term: Insert Major/Degree/Concentration:

(For Official Use Only)

DEPARTMENT RECOMMENDATION

____ Admit ____ Admit Conditionally ____ Admit 10% Exception ____ Deny

Justify 10% Exception or List Conditions:

Department Signature: Date:

COLLEGE RECOMMENDATION

____ Admit ____ Admit Conditionally ____ Admit 10% Exception ____ Deny

Justify 10% Exception or List Conditions:

College Signature: Date:

GRADUATE ADMISSIONS RECOMMENDATION

____ Admit ____ Admit Conditionally ____ Admit 10% Exception ____ Deny

Justify 10% Exception or List Conditions:

Admissions Signature: Date:

Revised10/2014