MIDLANDS STATE UNIVERSITY

ADMISSIONS, REGISTRATION AND STUDENT STATISTICS

Deferment of Studies Form
(To be completed in Hexatruple i.e. 6)

Surname …………………………………. First Name(s) ………………………………

Registration No ……………..…………Level …….…………Sex………………………

Faculty………………………………………..Department……………………………….

Degree Programme ………………………………………………………….……………

Mode of Entry (Tick Appropriate) Conventional, Parallel, Visiting School or Block

Release

I hereby request to defer my studies

as from………………………………to……………………………………..(period).

Applicant’s Signature:…………………..…………….Date:…………………………….

Recommended/ Not Recommended

Faculty Administrator’s Comment: study period lapses ……..……………………......

Signature ………………………………………………………… Date: …………….......

Recommended/ Not Recommended

Departmental Chairperson: ………………………………..Date: ……………………

Chairperson’s Comments.......................................................................................................

Approved/ Not Approved

Executive Dean of Faculty: ……………………………...Date: ……………………….

Student Accounts
Signature: ………………………………………….Date …………………………

Approved/ Not Approved

Deputy Registrar Academic: ………………………… .Date: ………………………

Admissions and Registration

Signature:………………………………………………….Date………………………….

Distribution: i) Registration Office. ii) Department. iii) Student Accounts

iv) Central Records. v) Information Technology Services. vi) Student.