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Extensionrequestform

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International Student Services (ISS), Edmonds Community College, 20000 68th Ave. W. Lynnwood, WA 98036
Phone: (425)640-1518, Fax: (425)774-0455, E-mail: iss_desk@edcc.edu, Web: http://www.edcc.edu/international/
Page 1 of 2
I-20 Program Extension Request Form
For College Students in F-1 Status
STUDENT TO COMPLETE:
_____________________________________ _______________________________
LAST NAME FIRST NAME STUDENT ID
Current Year: Current Quarter: Fall Winter Spring Summer
Phone number: E-mail:
Current address in the U.S.:
Procedures for college students to request an I-20 extension:
1. Visit ISS: Before your I-20 expires, visit the ISS office during drop-in advising times (10:30-11:30AM
except Wed; or 3:30-4:30pm M-F) to talk with an ISS Advisor about the I-20 extension process. If you
need to discuss your eligibility or have additional questions about your F-1 status, I-20 or visa, make an
appointment with an ISS advisor by visiting the office, or call (425) 640-1518.
2. Meet with an Academic Advisor: Make an appointment with an Academic Advisor in Lynnwood Hall,
call: 425-640-1458. If there are no appointments, please ask about your other options for seeing an
Academic Advisor.
o When you go to your advising appointment in Lynnwood Hall, bring with you the following
items:
Your unofficial transcript
Your current class schedule(s)
The Program Requirement Sheet for the degree you are pursuing
Any other applicable academic planning materials
*The Academic Advisor will do an unofficial evaluation of your college credits, then complete and sign the
Advisor section of this I-20 Program Extension Form (see reverse side)
3. Bring the completed form to the ISS office. You may submit it to the ISS front desk to be given to an
ISS Advisor.
*An ISS Advisor will review your request and contact you if any additional information is needed. Once
your request is approved, you will be issued a new I-20 with a new program end date and the ISS office will
contact you to ask you to visit the office to pick it up.
ISS FRONT OFFICE USE ONLY:
Received by: Date received: Given to (advisor):
ISS ADVISOR:
Approved Database updated SEVIS updated / I-20 issued Advisor initials:____________
Note:
International Student Services (ISS), Edmonds Community College, 20000 68th Ave. W. Lynnwood, WA 98036
Phone: (425)640-1518, Fax: (425)774-0455, E-mail: iss_desk@edcc.edu, Web: http://www.edcc.edu/international/
Page 2 of 2
I-20 Program Extension Request Form
For College Students in F-1 Status
Faculty/Academic Advisor to Complete:
The student named on the previous page is requesting an extension of his or her student immigration status (i.e. “I-20
extension”). This form is designed to facilitate the communication of academic information required by US immigration
regulations to the International Student Services office for the purpose of granting an extension. Please complete the
form in full and return it to the student.
The student is engaged in the following academic program:
Degree or Certificate: Major:
Number of credits remaining to complete the degree/certificate requirements:
Student is expected to complete the degree / certificate: YEAR: Quarter: FALL WINTER
SPRING SUMMER
Is this student making normal progress towards completion of his or her current program? YES NO
This student has not yet completed the current program of study due to (please check any one that applies):
Delay caused by a change in major field of study or degree program
No unusual delay. The original length of time given to complete studies was not sufficient for an average
student in this program.
Student needs additional courses to complete degree requirements.
Student needs additional courses for university transfer.
Other compelling academic reason for delay :
Remarks:__________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Faculty/ Advisor Name: Title:
Signature: Date:
Phone # / Extension: E-mail:
Office/Department: _________________________________________________________________________
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Completed 18 December 2019

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