Kettering University | Office of Admissions Kimberlie Dolan, International Admissions Liaison
1700 University Avenue | Flint, MI 48504 Phone: (810) 762-9568 | firstname.lastname@example.org
If you are an international student currently attending a college or university in the United States and have decided to apply to Kettering
University (KU), please complete the student section and submit this form to the International Student Advisor at your current
institution. International students transferring from another U.S. institution to Kettering University must transfer schools according to
U.S. Citizens and Immigration Services (USCIS) regulations.
Part I. To be completed by Student:
If you are currently attending a college or university in the United States, please complete the student section and submit this form to the
International Student Advisor at your current institution. The advisor should complete this form and fax it directly to our office.
________________________________________ ____________________________________ ____________________________
Print: (Last Name) (First Name) (Middle Name)
I hereby authorize the International Student Advisor at the most recent U.S. college/university I attended to complete this form and fax it directly to Kettering University in Flint, Michigan.
____________________________________________________ ________________________ __________________________________ __________________________
(Student Applicant’s Signature) (Date) (Phone Number) (First Term of Attendance at KU)
Part II. To be completed by International Student Advisor/Designated School Official:
The above-named student has applied to Kettering University. In compliance with USCIS regulations we request confirmation of his/her status at
your institution before considering this student for admission to Kettering University. Kettering University School Code: DET214F03130000
SEVIS ID Number ________________________________ Initial date of enrollment at your institution: ________________________
Date of last attendance at your school: ______________________ F-1 Completion Date on I-20: _______________________
Date Record Will Be Released in SEVIS: ______________________________
Please check one of the following:
The student is in good standing and is/has been pursuing a full course of study.
The student is out of status and a reinstatement to student status was filed.
The student is out of status, and we will advise him/her to apply for reinstatement upon receipt of a new SEVIS I-20 from Kettering University.
Name and Title of Designated School Official Completing this Form Name of Institution
____________________________________________ _____________________________ ______________________________________
City, State, and Zip Code Telephone Number E-Mail Address
Please send this completed International Student F-1 Transfer-In form to Kettering University’s Admissions Office
via fax to the attention of Kimberlie at (810) 762-9837 or via email to email@example.com
Would this student be permitted to continue or return to your institution? YES NO
If your answer to the above question is NO, please explain: ______________________________________________________________________
Please indicate if student is currently on Optional Practical Training (OPT). YES NO
Please provide date which appears on SEVIS I-20 which states OPT will end on: ________________________________