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Deferment Forms Revised2018

The document is an application form for students at Moi University to defer courses or withdraw from the university. It lists reasons for deferring such as short courses, illness, family or financial problems. It also lists reasons for withdrawing such as transferring schools, inability to handle the course, financial or personal problems. It outlines signatures needed from the Dean of the student's faculty, the Dean of Students, and the Deputy Vice Chancellor of Student Affairs to approve the request.

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Frank Kutia Kay
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22 views

Deferment Forms Revised2018

The document is an application form for students at Moi University to defer courses or withdraw from the university. It lists reasons for deferring such as short courses, illness, family or financial problems. It also lists reasons for withdrawing such as transferring schools, inability to handle the course, financial or personal problems. It outlines signatures needed from the Dean of the student's faculty, the Dean of Students, and the Deputy Vice Chancellor of Student Affairs to approve the request.

Uploaded by

Frank Kutia Kay
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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MOI UNIVERSITY

ISO 9001:2008 Certified Institution

APPLICATION FORM FOR DEFERMENT OF COURSES AND WITHDRAWAL FROM THE


UNIVERSITY (FIVE (5) COPIES)

PART A (I) DEFERMENTS OF COURSES


I Mr. /Mrs. /Miss______________________________Reg. No.:______________Year of Study_________ Wish to
apply to be allowed to suspend/defer my courses of study from (Date) ______ to________ (Date) on account of the
following: (Delete the inapplicable).
1. Short course outside the country
2. Ill health
3. Family problems
4. Financial difficulties
5. Other problems – please specify here below
_____________________________________________________________________________________________
_____________________________________________________________________________________________
NAME OF STUDENT___________________________________ SIGN. _____________ DATE_____________

PART A (II) – WITHDRAWAL FROM UNIVERSITY


I Mr./Mrs./Miss______________________________Reg. No.:______________Year of Study_________ having
considered all factors, I have decided to withdraw from University with effect from (Date)______ _____my main
reason(s) of withdrawing is/are as follows: (Delete the inapplicable).
1. To go to another institution
2. Inability to cope with the course
3. Financial problems
4. Personal and other social problems.
5. If non of the above please indicate here below
______________________________________________________________________________________________________
______________________________________________________________________________________________________

NAME OF STUDENT___________________________________ SIGN. _____________ DATE_____________

(B) DEAN OF FACULTY/SCHOOL


I have to-date assessed the request for deferment or/withdrawal and I have accepted that the applicant may
suspend/withdraw from the course with effect from Date:____________ to resume_________ date______________.

SIGNATURE _____________________ DATE_______________________

DEAN FACULTY/SCHOOL OF____________________________________________

(C) DEAN OF STUDENTS


I recommend that the applicant may proceed to suspend/withdraw from the course with effect from Date__________
to (Date) __________________

SIGNATURE ______________________________ DATE_________________


DEAN OF STUDENTS

(D) DEPUTY VICE CHANCELLOR – STUDENT AFFAIRS (S.A)


The student has been granted permission to suspend/withdraw from the University

SIGNATURE ______________________________ ____________________


DVC, S.A DATE

© Office of the Dean of Students

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