The University of Akron
Graduate Assistantship and/or
Tuition Award Extension Request
EMPL ID#:
Academic Department:
Requesting extension through:
First Name:
Street Address:
City:
UA E-Mail:
SCH Required for Degree: SCH Accumulated:
MI:
State:
Date:
Last Name:
Zip:
International Student
Master’s Student
Domestic Student
Doctoral Student
In-State
Out-of-State
Date Received by
the Graduate School:
Graduate School Approval Date
For Graduate School Use Only
The extension is granted with the following contingencies or conditions.
Chair/Director of Appointee’s Academic Department Date
Head of Service Department or Grant Director Date
(if different from the Chair/Director of the academic department)
Appointee Date
GA Semesters Accumulated:
Tuition Award Semesters Accumulated:
Graduate Assistantship Extension Request
Tuition Award Extension Request
Reason for request for extension:
Please describe with specic detail the circumstance that merits consideration for an extension of a Graduate Assistantship or Tuition Award funding.
Additional sheets may be attached if necessary.
Department of Service:
Teaching Assistant
Administrative Assistant
Research Assistant
