rev. 07/2012 1 of 1
F-1 international student intending to transfer to another college or university must complete and submit
this form to the Office of International Student Services (OISS). The information requested on this form is
required by Houston Community College (HCC) in order to release your SEVIS I-20 Form record to
another institution. Please submit this completed form along with a letter of admission from the
institution to which you intend to transfer.
Student Information
_________________________________ ________________________ _________________________
Family (Last) Name First Name Middle Name
_________________________________ ________________________ _________________________
Major of Study US Phone Number Email Address
Reason for Transfer Request (Check all that apply)
Graduation
Below Status
Unable to Register
Financial Difficulties
Academic Suspension
OPT Completion
Course Availability/Location
Other: _____________________________________________
Transfer School Information
_________________________________ ________________________ _________________________
Name of Transfer School Campus/Branch Location Transfer School Address
(if applicable)
_________________________________ ________________________ _________________________
Phone # to the International Office Fax # of International Office Semester/Year of Acceptance
*Requested Transfer Release Date ____/_____/_____ Start Date at New School ___/____/_____
*The transfer will not be processed without a date & subject to approval.
Note: Although you may be applying to multiple new schools, the OISS can only indicate one transfer
school in SEVIS. The transfer release date will be the end of the current term or session. If you decide to
cancel your transfer you must notify the OISS before your transfer release date given that after the
release date has been reached HCC will no longer have access to your SEVIS record. Finally, be aware
that any form of employment you might have under your F-1 student status must end the same day as
your SEVIS release date.
I give HCC permission to release the information requested on this form:
_____________________________ _________________________________ ________________
Name (please print) Signature Date (MM/DD/YY)
Transfer Out Request Form
HCC ID: ___________________________
SEVIS ID: ___________________________
