TENNESSEE TECHNOLOGICAL UNIVERSITY
INTERNATIONAL GRADUATE APPLICANTS ADVISOR REFERENCE FORM
If you are currently enrolled in, have ever attended, or have graduated from a U.S. College or University, this reference form must be submitted
as a part of your application. Please sign the authorization and request that your International Student Advisor complete this form and fax it or
mail it directly to the address shown below.
INTERNATIONAL STUDENT AUTHORIZATION:
I, (print name as it appears on your application) authorize the
International Student Advisor to provide the information requested, as a part of my application for
admission to Tennessee Technological University.
Signature: _Date:
TO BE COMPLETED BY INTERNATIONAL STUDENT ADVISOR:
ACADEMIC PROGRESS:
Dates of Attendance: From to Degree: Major:
(Expected) Date of Graduation: Is the Student in good academic standing? Yes No
If no, explain:
IMMIGRATION STATUS: (FOR F-1 AND J-1 VISA HOLDERS ONLY)
Visa Type: Admission #: Date of Entry:
SEVIS ID#: I-20 Expiration Date: SEVIS RELEASE DATE:
Is the Student currently in status? Yes No
If no, explain:
FINANCIAL STATUS: (FOR F-1 AND J-1 VISA HOLDERS ONLY)
Does the Student have any outstanding debts? Yes No
If yes, amount owed:
_.
Has the Student encountered any financial difficulties? Yes No
If yes, explain:
Please attach any additional comments
Advisor’s Signature: Date:
Advisor’s Name: Title:
Institution Name:
Address:
Tennessee Technological University, Graduate Studies, Box 5012, Cookeville, TN 38505-0001 USA
Tel: (931) 372-3233 Fax: (931) 372-3497· E-mail: gradstudies@tntech.edu · URL: http://www.tntech.edu/graduatestudies/
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