Transfer Form for International Students
INTERNATIONAL TRANSFER FORM Part 1: To be completed by the applicant
Please complete Part 1 of this form and give it to your present International Student Advisor
to complete Part 2.
I authorize my present International Student Advisor to provide the information below.
Student’s Name (Print): _____________________ / ________________________
(Last or Family Name) (First Name)
Student’s Signature: ________________________ Date: ________________
Part 2: To be completed by the International Student Advisor
The above named student has applied and has been accepted at Halifax Community
College. Please answer the questions below and return this form to:
Halifax Community College, Admissions Office, 200 College Drive, Weldon, NC 27890,
Fax: 252-538-4311, SEVIS ID #: ATL214F10928000
1. The student pursued a full course of study the last semester at your institution.
Yes No
2. What were the student’s dates of attendance? _________________________________
3. The student has met all financial obligations to this institution. Yes No
4. The student is available to transfer. Yes No
5. The student's SEVIS ID number is: __________________________________
I certify that the preceding is correct.
Designated School Official: (
Print) _____________________ Title: ____________________
School: _________________________ Address: ________________________________
Phone: ______________________________
Signature: _________________________________ Date: _________________________
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