UUMCAS/AHSGS/0020

APPLICATION FOR DEFERMENT OF STUDY

INSTRUCTIONS
To applicant: Please complete Section A and submit this form to the Dean of the Awang Had Salleh Graduate School of
Arts and Sciences, UUM College Arts and Sciences.

SECTION A: APPLICANT’S GENERAL INFORMATION

Name of Applicant:
Matric No.: Programme:
Mailing Address:
Current CGPA:
Contact No.:
Programme Structure:
Mode of Study: ( ) Coursework
( )Full-time ( ) Part-time ( ) Coursework and Thesis/Dissertation
( ) Research

Semester of Deferment: Jan/February/May/ September Year: 20__ / 20__

Reason (s) for deferment (please use additional paper if necessary)

Applicant’s Signature:

Method of Collection the Letter: [ ] By Post [ ] By Email [ ] Collect from AHSGS

SECTION B: FOR OFFICE USE ONLY

Approved ( ) Rejected ( )

Received Date : Recorded Date:

Signature and stamp:

Name :