F-1 Student
SEVIS Transfer-Out Request Form
A COPY OF ADMISSION LETTER IS REQUIRED.
Last name:
First name:
SID:
965
Phone #:
Alternate email address:
Transfer to:
SEVIS School Code:
City:
State:
Circle one:
Starting in
Fall
Winter
Spring
Summer
[Quarter•Semester•Session]
Starting date at the new school:
Month
Date
Year
I have been admitted to the above school and authorize International Education at Shoreline Community
College to electronically release my SEVIS record to this school.
The release date that I request is:
(Usually the last day of the quarter. Some
exceptions apply. This will not be the date that
has been past already.)
Month
Date
Year
Student signature:
Date:
Advisor’s signature
Date:
Admission letter attached (required)
Immigration Use Only
Confirmed transfer eligibility
initial
Date
SEVIS
initial
Date
FSA
Transfer-out s
cheduled
Added Transfer-out info in Profile
initial
Date
Updated profil
e "F-1T/O" "Complete"
initial
Date
initial
Date
Updated bio section
Front Desk Use Only
File
Archived
initial
Date
Revised 5/2017
Form updated 05/23/16
DEPARTURE SURVEY - UNIVERSITY
Last quarter and year of attendance:_____________________ Country of Citizenship:___________________________
Name of agent used when applying, if any:______________________________________________________________
PLEASE LIST ALL SCHOOLS YOU APPLIED TO (FULL NAME)
MAJOR
ADMITTED
NOT ADMITTED
UNKNOWN
Would you be willing to talk with other students who may wish to transfer to that school in the future? YES/NO
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achievements and accomplishments as you continue on with your academic journey!
Thank you very much! It’s been a pleasure having you here at Shoreline Community College