__________________________________________________________________________________________________
International Student
Transfer In Notification
Student Name: ____________________________________________ SEVIS ID Number: _________________________
Date of SEVIS Release: __________________________________________
Instructions: Please have your Current Primary/Designated School Official complete and return to address below.
1. What is the current immigration status of the applicant?______________________________________________
2. Is your school where the student was last authorized to attend?________________________________________
3. For F-1 visa:
a. What is the students’ admission number?______________________________________________________
b. What is the date of completion on the student’s latest I-20 to your school?___________________________
c. What is the length of the program?___________________________________________________________
d. Has the student used any practical training?____________________________________________________
If yes, then how many months of: Curricular Practical Training _____________________________________
Optional Practical Training _______________________________________
Is the student engaged in optional practical training before/after completion of his/her studies?__________
If yes, please include exact dates: _____________________________________________________________
4. Has the student maintained full-time studies as defined by the regulations, including any certificates granted by you
under 8CFR 214.2(f) (6) (iii)?_______________________________________________________________________
5. The term of the student’s last enrollment was the __________________semester of __________________year.
6. On what date did the applicant first arrive in the United States?___________________________________________
7. Could the applicant continue to study at your institution?________________________________________________
If not, then why not?______________________________________________________________________________
Signature of Designated School Official:_____________________________________________Date:________________
Printed Name of Designated School Official:______________________________________________________________
Contact Number: ______________________________Email Address: _________________________________________
Name and Address of Institution: ______________________________________________________________________
Return form to:
Ms. Kathie Conarck, Associate Director of International Programs
Farmingdale State College
Laffin Hall – Room 302
2350 Broadhollow Road
Farmingdale, NY 11735
P: 631-420-2460 F: 631-420-2780 Email: international@farmingdale.edu
Office of International Education and Programs 12/2015
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