OFFICE OF ADMISSIONS
International Student Admissions
Transfer / Transient Clearance Form
F-1, M-1 and J-1 visa holders who wish to attend Daytona State College as a transfer or transient student are required to submit this form along with
their Application for Admission, most recent I-20 or DS-2019, I-94, and passport. Note: J-1 holders may attend as special-credit students while in
valid J-1 status but will be required to undergo a change of status if they wish to attend Daytona State College as a degree-seeking student.
Please return the completed form to the Admissions Office. Mail to Admissions Office, Daytona State College, 1200 W. International Speedway Blvd.
Daytona Beach, FL 32114.
STUDENT INFORMATION
Student Name:
Current Visa:
F-1 M-1
SEVIS #
I plan to attend Daytona State as a transfer / transient student and authorize my home institution or sponsoring entity to release information
necessary to facilitate my admission to Daytona State.
J-1
To be completed by the student:
Student Signature Date
HOME INSTITUTION / PROGRAM SPONSOR VERIFICATION
To be completed by the Designated School Official (F-1, M-1) or Program Sponsor (J-1):
This student wishes to attend Daytona State College as either a transfer or transient student. Please provide the information requested to help us
determine the student's eligibility. This information is kept confidential by the Admissions Office and is not for use by any other office.
For all students:
1. To your knowledge is this student currently in status with DHS?
2. Is the student eligible to return to / continue at your institution?
For transfer students:
1. Has the student experienced any financial difficulties?
2. Has the student been granted any practical training?
3. Date of graduation or last term attended:
If no, please explain:
If yes, please explain:
Curricular Training Optional Training
Dates: to
Curricular Training Optional Training
Dates: to
4. Suggested SEVIS release date:
School / Program Official Signature Date
School / Program Official Name and Title (print) School / Program Official Telephone
School Seal / Stamp REQUIRED
Please do not release without notification of final acceptance to Daytona State.
Yes No
Yes No
Yes No
Yes No
1. Does the student have your permission to attend classes at Daytona State while on your I-20 / DS-2019?
Yes No
For transient students:
If no, please explain:
3/26/10 km
