Usf St. Petersburg Graduate Studies Deferment Of Admission Request Form printable pdf download

Deferment of Admission Request Form

USF St. Petersburg Graduate Studies

140 Seventh Avenue South, BAY 204

St. Petersburg, Florida 33701-5016

Telephone: (727) 873-4567 Fax: (727) 873-4889

INSTRUCTIONS: This request must be submitted directly to the graduate program for which a deferment of

admission is being sought. For program locations, go online to:

Please fill out

completely; failure to do so will delay the procession of your request.

International Students Only:

International students must also provide a new Financial Statement, Promissory Letter dated within six months of

the desired term of entry. Please refer to the International Admissions website for further information:

University ID #: U-_____________________________________________________________________

Legal Name:__________________________________________________________________________________

Last Name

First Name

Middle Name

_____________________________________________________________________________________________________________________

Street Address Apartment Number

_____________________________________________________________________________________________________________________

City/State/Zip Code County

_____________________________________________________________________________________________________________________

Telephone Number (please include area code)

Fax Number (please include area code)

E-mail Address

_____________________________________________________________________________________________________________________

Signature of Student Requesting Deferment

Date:

Term Student is

TERM OF

GRADUATE PROGRAM

Deferring to

DEFERMENT

DEPARTMENT RECOMMENDATION

_____ Admit

_____ Deny

Justification for 10% Exception or Conditions:______________________________________________________________________________

Department Signature:_________________________________________________________Date:____________________________________

COLLEGE RECOMMENDATION

_____ Admit

_____ Deny

Justification for 10% Exception or Conditions:______________________________________________________________________________

Department Signature:_________________________________________________________Date:____________________________________

GRADUATE STUDIES RECOMMENDATION

_____ Admit

_____ Deny

Justification for 10% Exception or Conditions:______________________________________________________________________________

Department Signature:_________________________________________________________Date:____________________________________

04/2009

Usf St. Petersburg Graduate Studies Deferment Of Admission Request Form

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