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Request for a Travel Signature
(Signatures are valid for 12 months)
Please complete this form, print it and bring it with your current form I-20 to Ms. Levesque, Fenwick 204.
Tina Chen will sign your I-20 and have it ready for you to pick up within 48 hours.
If you also would like to schedule an appointment to speak with Tina, please check here:
Name: _________________________________________
Class Year: ____________
Email: __________________________________
Cell phone: ______________________________
HC ID #: _________________________________
Major 1: ________________________________
Major 2: ________________________________
Minor: __________________________________
My passport expires on: _____________________
(mm/dd/yyyy)
My U.S. visa expires on: _____________________
(mm/dd/yyyy)
My current travel plans include:
Country: _________________ date of campus departure: _________________
(mm/dd/yyyy)
I plan to return to Holy Cross on: _________________
(mm/dd/yyyy)
I understand that I am expected to arrange my travel so that I attend all my classes.
Signature: ___________________________________ Date: __________________
(mm/dd/yyyy)
