Deferment Request Form

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Deferment Request Form

The University of Texas Rio Grande Valley (UTRGV) School of Nursing accepts limited admissions to a specific term and year. Accepted applicants will enroll for the accepted term. Complete this form only if unable to accept admission for the selected term/module. If a deferment request is not received within 30 days of the acceptance letter, the applicant must reapply for open future terms. Deferrals are not guaranteed or automatically granted. If the deferment request is pending or not granted during an open admissions cycle, the applicant is required to submit a new application (non-refundable application fee). If a deferral is granted for the next term, a new application is not required. An applicant may be approved only once for an admission deferral. Deferment decisions are final and cannot be appealed.

Requester Information

Please complete the following information.

Student’s First and Last Name: (Required) Format: John Jonesd (Please include your full name)

SID#: (Required) Format: SID#

Program you were accepted for: (Required)

Semester and Year Accepted (Required) Format: Bachelors of Science in Education

Semester and Year requesting deferment (Required) Format: Note: Students may only defer until the next scheduled semester/module for the selected program.

Rationale for deferment request. Check all that apply. (Required)

Illness/medical issue (requires letter from health care provider with diagnosis and statement that enrollment may not be possible)

Participation in legal proceedings

Serious illness or death of an immediate family member

Military services (requires orders demonstrating inability to enroll)

Other (briefly explain and summarize information to protect your privacy): (Note: Financial or employment circumstances are not considered exceptional circumstances for admissions deferral. If the admission deferral is denied, the applicant must enroll, or the offer of admission will be terminated. )

Check to Accept

I understand that if granted a deferment and do not start the program as approved, I will reapply for a future term.

Student’s Signature: (Required) (My signature attests to the accuracy of the above information. )

Date: (Required) Format: mm/dd/yyyy

Next Steps

Deferral request forms will be reviewed by the program Admissions, Progression, and Graduation Committee (APG).
Applicants will be notified of the deferment decision approximately 14 business days from submission via email.

Deferment Request Form

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Requester Information

Next Steps

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