Please return the completed form to:  International Office,  University of Central Oklahoma,  100 N. University Dr.,  Edmond, OK  73034-5209,
Fax: 405-974-3842

TO THE PROSPECTIVE STUDENT:  In order to complete the transfer to the University of Central Oklahoma, you must have this form completed by the last institution you were authorized by the Immigration and Naturalization Service (INS) to attend.

 I, _________________________________________ give permission for my current institution

   (PRINT NAME CLEARLY:  Last, First, Middle, Maiden)

to release the following information.       _______________________________________

                                                                        Signature of student 

*********************************************************************************************

TO THE INTERNATIONAL ADVISOR:  Please complete the following information for the above student and return with a copy of student's I-20 to the above address.

 

Student’s Visa Type: _________               SEVIS Number __________________________________
Please do not transfer out his/her record on SEVIS until notified of admission by our office

 

First semester/quarter/session (circle one) in attendance at your school: _______________________

           

Last semester/quarter/session (circle one) in attendance at your school: _______________________

 

Currently or last enrolled in __________semester/quarter (circle one) credit hours.

 

Is student is pursuing a full course of study and in good standing with INS therefore eligible to transfer?   ___Yes   ___No, because:

 

Is student in good academic standing?  ___Yes   ___No, because:             

 

Is student in good financial standing?  ___Yes   ___No, because:

 

Has student ever apply for reinstatement of status?   ___No   ___Yes;  When?

 

Has student been granted off-campus or practical training employment?  ___No   ___Yes

  If yes, specify type/s and dates:

 

Has the student been the subject of disciplinary action while in your school?  ___No   ___Yes

  If yes, briefly explain:


 

______________________________________________________________________________

Signature                                                               Name and Title of Official                                                   Date

 

______________________________________________________________________________

                                    Institution Name and Address                                                          E-mail Address

(INSTITUTIONAL SEAL)