Revised10/2014
Deferment of Admission Request Form
OFFICE OF GRADUATE ADMISSIONS
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 Num
ber (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:
