Graduate Studies Office
Center for Business 115
International Student Transfer Form
ONLY students currently attending colleges and universities in the United States should complete this form.
Student:
If you are currently attending a college or university in the United States, please have your international student advisor at
that institution complete this form and upload the form to your application file on the self-service center
.
Student:
Last Name/Surname First Name Middle Name
Students Social Security Number (if previously assigned):
I hereby authorize the international student advisor at the most recent U.S. university/college I attended to complete this
form and mail, e-mail or fax it directly to International Student Services at Minnesota State University Moorhead.
Applicant’s Signature:
Date:
International Student Advisor:
The international student whose name appears above has applied for graduate admission to Minnesota State University
Moorhead. Before the student’s USCIS transfer process is complete, we need verification of the information provide on
the student’s application form, as well as completion of the questions below:
Is this student in good standing at your institution? Yes No
Has this student maintained full-time academic status as required by USCIS? Yes No
Is the student eligible to return or continue at your institution? Yes No
Student’s initial date of attendance: ___________________________________________________________
Student’s last date of attendance: ___________________________________________________________ __
What visa status does the student currently hold? _________________________________________________
Please list the student’s SEVIS Number: _______________________________________________________
Please list any approved periods of CPT/OPT:
Please list any approved periods of reduced
course load, medical or other:
Has the student experienced any financial problems while attending your university? Yes No
International Student Advisor Name:
Institution Name:
Address:
City/State/Zip:
Phone Number:
E-mail:
Signature of International Student Advisor: Date: