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BRIGHAM YOUNG UNIVERSITY

LDS M ISSION ARY EN R OLLM EN T AN D SCH OL AR SH IP DEF ER M EN T APPLI CAT I ON

See back side for instructions.


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EnRollmEnt dEfERmEnt (to be completed by student)

Name
Last First Middle

BYU ID Birth date


Number and street Month

/
Day Year

Permanent address

City

State/Province

Male

Female )
Area code

Telephone (
Zip/Postal code Country

Number

E-mail
* E-mail required for all CES communication

If permanent resident, please list alien number Home ward Indicate the semester or term you plan to enroll upon your return (mark only one box): Year Home stake

SummerJune

FallSeptember

WinterJanuary

SpringApril

Please mark the appropriate box (mark only one). I have been:

Attending BYU for one or more semesters as a day-time student. Dates of BYU Attendance ___ / ___ to ___ / ___ Accepted as an incoming freshman, but I am deferring attendance at BYU until I have completed an LDS mission. Accepted as a transfer student, but I am deferring attendance at BYU until I have completed an LDS mission. mtC entry date
Month

Current name of mission

/
Year

SCHOLARSHIP DEFERMENT (to be completed by student)


Check this box if you:

Wish to defer any unused portion of a BYU scholarship. Wish to apply for an academic award following your mission. Have applied for a scholarship but have not yet been notified regarding your application. If awarded, your new scholarship will be deferred automatically. Scholarship deferment is not official until you receive written approval from the Scholarship Office. note: National Merit scholars must contact the National Merit Scholarship Corporation. note: For off-campus scholarships, please contact your awarding institution.

CERtIfICatIon (to be completed by student)


I certify that all statements in this application are complete and true. I acknowledge that my admission and continuing status at Brigham Young University are conditional on such completeness and truthfulness.

Signature

Date

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To defer your enrollment and scholarship (if applicable) without reapplying, you must adhere to the following: 1. Be admitted as a regular day school, degree-seeking student at Brigham Young University. 2. If you are a current BYU student, enter the Missionary Training Center (MTC) before the end of next semester (fall or winter) following your last day school enrollment. If you are deferring admission before attending BYU day school, you should enter the MTC during the semester to which you have been admitted. 3. Do not attend or enroll at any college or university between leaving and returning to BYU. 4. Must not be dismissed from BYU. 5. Complete a full mission and receive an ecclesiastical endorsement from your mission president. Failure to complete the mission for any reason (i.e., medical, etc.) will void the deferment form and require a re-application to BYU. 6. BYU will NOT defer spring/summer scholarships
NOTE: A missionary deferment and continuing student deferment may not be taken back-to-back (consecutive semesters). Following your mission, you must enroll at Brigham Young University within a given time period, as noted below.

If you are registered for a future semester or term but will be unable to attend due to your mission, you are responsible for discontinuing from the courses prior to leaving the university. This completed form should be submitted to the BYU Admissions Office after receiving your mission call and before entering the Missionary Training Center. International students who are not permanent residents of the United States should complete the International Missionary Enrollment and Scholarship Deferment Application, (available at the Student Services Window, D-155 ASB, 801-422-2500) NOT THIS FORM.

Completed form must be returned to: IN PERSON:


STUDENT SERVICES wINDOw

PHONE: (801) 422-2507

D-155 ASB

MAILING ADDRESS:
BRIGHAM YOUNG UNIVERSITY OFFICE OF ADMISSIONS

Return from mission OctoberApril MaySeptember

Enroll no later than Fall semester Winter semester

A-41 ASB
PROVO , UT

84602-1110

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