Deferral Form

Student First Name

Student Last Name

Date of Birth

Phone number

High School name

High School Graduation Date

Requesting Deferral to

Reason for Deferral

Plan for the semester or year i will be deferring

I certify that I have read and agree to the following terms:

I have submitted my enrollment deposit at hood.edu/imablazer

I will initiate no new applications or submit an enrollment agreement to other colleges or universities

I will not enroll in any individual college courses to pursue college credit without pre-approval from the Hood College director of admission

I will not enroll in a degree program at another institution

I will contact the office of admission two months prior to the start of my re-enrollment date to confirm attendance and arrange for course registration and campus housing

I understand that I am not guaranteed all opportunities that were offered for fall 2021, including but not limited to the Chair of the Board Scholarship, Nursing program, Honors Program and Tuition Exchange.

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