Deferral of Admission Request Form
Email address *
Request for Admissions Deferral
PLEASE NOTE THE FOLLOWING:

This is a REQUEST for deferral. Upon completion of this form, the appropriate program will review your request for deferral to the term you have indicated below, and will decide whether to grant an official deferral. You will be notified when an official deferral decision has been made. No other forms or information are required for your deferral request. If you have additional questions, please send a separate e-mail to biomedgrad@georgetown.edu.

Scholarships do not transfer over to the deferred semester.

Students are only allowed ONE deferral request per admission for up to one year from the original term admitted.
APPLICANT NAME
First Name *
Please enter your given name.
Last Name *
Please enter your family name.
DATE OF BIRTH
Please indicate your date of birth.
Date of Birth *
MM
/
DD
/
YYYY
MAILING ADDRESS & CONTACT INFORMATION
Please enter your COMPLETE postal mailing address (Street address, Building No., Room No., City, State, Zip Code, including Country, if non-USA). We will update our university system with this information you provide.
Enter Your Complete Street Address and (if applicable) Building No., Room No. *
Enter Your City *
Enter Your State/Province *
Enter Your Zip/Postal Code *
Enter Your Country *
Next
Never submit passwords through Google Forms.
This form was created inside of Georgetown University. - Terms of Service