Fillable Transfer Request By submitting this form, I am (Casper College)

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Transfer Request By submitting this form, I am (Casper College)

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Transfer Request
By submitting this form, I am requesting a transfer to Casper College. My signature indicates that I am
giving permission for you to release transcripts and information related to my I-20.
Student Name (print) ___________________________________________________________________
Last First Middle
Anticipated semester and year of enrollment: Fall__________ Spring __________ Summer__________
Year Year Year
Please release the following information to Casper College for Admission Purposes.
_______________________________________________ __________________________
Student Signature Date
To be completed by Designated School Official (PDSO or DSO)
Type of Visa student currently holds _______ Admission Number on Form I-94 _________________
Was the student pursuing a full course of study for the term immediately preceding this transfer?
Yes___ No____ Explain if no____________________________________________________________
____________________________________________________________________________________
Has the student met all financial obligations to your institution? Yes_____ No_____
Dates of attendance at your school_________________________________________________________
___________________________________________ _______________________________________
Printed Name Title
___________________________________________ _______________________________________
Signature (PDSO/DSO) Telephone number
___________________________________________ _______________________________________
Name of Institution Date
__________________________________________ _______________________________________
Address City, State, Zip
Please return form to: Dr. Nicholas Whipps, SEVIS/DSO
125 College Drive
Casper, WY 82601
Fax 307-268-2611
nwhipps@caspercollege.edu
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Transfer Request By submitting this form, I am (Casper College)

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Completed 4 February 2021

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