Fillable Termination Future PlansNE Wfillible (Las Positas College)

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Termination Future PlansNE Wfillible (Las Positas College)

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For Staff Use Only
□ dropped future classes in Banner ______
□ updated in SEVIS _____
International Student Program
3033 Collier Canyon Road
Livermore, CA 94551-7650
Tel: 925.424.1540
Fax: 925.424.1877
Email: sday@laspositascollege.edu
Web: www.laspositascollege.edu/international
s
TERMINATION/ FUTURE PLANS FORM
Name:_____________________________
Student ID#:_________________________
I will be completing my studies at Las Positas College after the Fall / Spring) 20_____ Semester.
My last day with LPC will be ______________________ (date).
(This date is usually the last day of the semester. If you are transferring to another school, and this
program requires you to attend before your current semester is finished, please bring us your acceptance
letter and or orientation schedule).
For my future plans, I will: (please choose one with an “X”)
Depart the United States within 60 days of my termination date.
Transfer Out to another school. Name of School: ______________________
Please be advised that you are expected to complete your transfer within your 60 day grace
period. You should also plan to begin at the next available session at your new school. Contact
your new school for more information. You do not need to begin at your new school within
your 60 day grace period. You are allowed by the U.S. Department of Homeland Security a
maximum of 5 months of staying in the United States while waiting to begin your next program.
I will show my International Student Advisor an acceptance letter from my new program and present
a Transfer Form (if available) and my International Student Advisor will complete my Transfer.
Undecided. I will tell my International Student Advisor if I need a transfer Form.
Other. Please explain:
I understand that a Las Positas College International Student Program Designated School Official (DSO)
will use this information in updating your SEVIS record. I further understand that once SEVIS has been
updated, it may not be possible to change.
______________________________
Signature
______________________________
Date
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Termination Future PlansNE Wfillible (Las Positas College)

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Completed 19 July 2020

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