Center for International Education
Northern Arizona University
PO Box 5598
Flagstaff, AZ 86011-5598
Phone: (928) 523-2409
studynau@nau.edu
SEVIS Transfer-In Verification Form
This form is required of all F-1 or J-1 international students admitted full-time to Northern Arizona University and who are
currently enrolled at another U.S. school/college/university OR are in a period of Post-Completion Optional Practical
Training (OPT) or Academic Training (AT).
• A student cannot be issued a Certificate of Eligibility (I-20 or DS-2019) from Northern Arizona University until this form is
completed in full, the SEVIS record release has been scheduled, and the transfer release date has passed.
• If student needs to travel out of the country and plans to return after the SEVIS release date, please be aware that he/she must
be in possession of an I-20 or DS-2019 form issued by Northern Arizona University and a valid visa.
Part 1: To be completed by the STUDENT:
*Name should be written as shown on your government issued passport.
Family Name:___________________ First Name:____________________ Middle Name:__________
NAU Student ID #: _______________ Date of Birth:______________ SEVIS ID #_______________
I-20 Shipment Information (through Federal Express): ____________________________________________
(Street Address)
____________________________________________
(City) (State) (Zip code)
____________________________________
(Phone Number at this address)
Address Effective Until: ______________________
(Month Day Year)
I hereby authorize the Designated School Official (DSO/ARO) to provide the information below to NAU.
Student Signature:_________________________________ Date: ________________________
Part 2: To be completed by the international advisor (DSO/ARO):
The above named student intends to transfer to Northern Arizona University. Please email a copy of this form to our office
at: studynau@nau.edu. Our SEVIS code is: PHO214F00090000 / our program # is: P-1-04989.
To the best of your knowledge, is the student named above in status according to United States
Department of Homeland Security regulations and eligible for transfer?
Yes______ No_______ (Please note, NAU does not accept completed OR terminated records)
Is the student currently on OPT? Yes____ No____
SEVIS Transfer Date: _______________________
DSO/ARO: I certify that the above information is valid and correct:
Name: __________________________________Email Address: ______________________________
Institution: ______________________________________ Phone Number: _____________________
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