I N T E R N A T I O N A L P R O G R A M S
Box 9597, Roanoke, Virginia 24020-1597
(800) 511-6612 • Fax: (540) 362-6693
E-mail: abroad@hollins.edu
02/17
F-1 Student Transfer-In Form
Part 1. To the Student: Please complete Part 1 of this form and then ask the international student
adviser/Designated School Officer at your current school to complete Part 2 and return the form to
Hollins University.
Full Name: Date of Birth:
I intend to transfer to Hollins University for the 20___ term and hereby authorize the
Designated School Officer at my current school to provide the information requested below to Hollins
University.
Student’s signature Date
Part 2. To the International Student Adviser/DSO: The student named above has been accepted to
Hollins University. Please complete this section and return the form to Hollins at the address or fax
number listed below.
Student’s current visa status: SEVIS ID number:
Program completion date listed on the student’s current I-20:
To the best of your knowledge, has this student maintained status? Yes No
If no, please explain: ___________________________________________________________________
_____________________________________________________________________________________
Dates of any periods of CPT: _____________________________________________________________
Dates of any periods of OPT: _____________________________________________________________
Comments:
Name: Title:
E-Mail: Phone:
Institution (as listed in SEVIS) School Code
Signature Date
