Center for International Education and Programs at Elgin Community College | 1700 Spartan Drive, B105 | Elgin, IL 60123
Email: international@elgin.edu | Phone: +1.847.214.7809 | Fax: +1.847.931.4897
07/2018
Transfer Out Request Form
For F-1 international students planning to transfer to another U.S. institution
Student Information
Name: _______________________________________________ Student ID:__________________________
Last First Middle
Address: _____________________________________________ City:________________________________
State: _________________ Zip Code : ____________________ Phone : ______________________________
Email: _______________________________________________
Last Semester of Enrollment:_____________
New School Information
Name of Institution: _____________________________________
Institution’s Phone: ____________________
Institution’s Address: ____________________________________________________________________________
Requested “Transfer Out” Date: ___________________________ Program Start Date: ____________________
Required Documentation
Attach a copy of your admission letter from your new school
I certify that I have read this form and certify that all information is correct to the best of my knowledge. I
acknowledge that my SEVIS record will be released to the new school indicated above as of the date requested. I
understand that the release is non-reversible and will cancel any post-completion OPT.
____________________________________________ ________________________________
Student Signature Date
Please allow one week for processing.
This information is subject to change without notice. For individual questions, please contact the
Center for International Education and Programs for an appointment.
For office use only:
Date received: _____________ Documentation Attached: Yes No
SEVIS release date: _____________ DSO Approval Signature: _______________________________
