International Student Services
Transfer Out Request Form
century.edu | 651.779.3300
3300 Century Avenue North, White Bear Lake, MN
An International Student who is transferring out of Century College to another educational institution WITHIN the
United States must request to have their SEVIS record transferred. For a student to retain their F-1 status, Century
College must transfer out the SEVIS record no later than 60 days after their degree completion or OPT end date on
their EAD card.
Students, although you may apply to multiple new schools you can only request one
transfer of your SEVIS record
out from Century College. Please be sure you are certain of your transfer plans before requesting your SEVIS
record be transferred. When you are ready to make the request, please complete this form.
To Be Completed by the Student: Please Type or Print Clearly
Student Name: ________________________________________________________________________________
Student ID: ______________________ Phone:__________________ Email:_______________________________
U.S. Address: ________________________________________________________________________________
Name of NEW U.S. School you are transferring to: ___________________________________________________
Date you are requesting to have your SEVIS Record transferred to the new school: _________________________
NEW School Phone Number:__________________ NEW School SEVIS Code:____________________________
You must attach the following documents to this form:
1. A completed Authorization for the Release of Student Information
a. Section 1: Fill out your personal information
b. Section 2: Fill out the transfer school’s information
i. Name: Name of the School; Relationship to Student: Transfer School;
ii. Check the box for Other and write “SEVIS Record” on that line
c. Section 3: Sign and Date
2. Your acceptance letter from your new college or university. The acceptance letter must indicate that you are
accepted as an International Student
3. If applicable, NEW school’s Transfer Form (may be called Transfer Verification Form or Transfer Eligibility Form)
By signing this form I certify that I will attend the above named school. I understand that my SEVIS record can only
be released to one school. I am aware that I must drop any courses I am registered for at Century College. If I
choose not to drop the courses, I understand I will be responsible for the tuition and fees.
Student Signature Date
Students, please submit completed form and required attachments to International Student Services, W1221
at least 7 days prior to the requested transfer date.
Century College is a member of Minnesota State. We are an affirmative action, equal opportunity employer and educator. This document
can be available in alternative formats to individuals with disabilities by calling 651.773.1745 or emailing firstname.lastname@example.org.
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