Please return the completed form to:

Office of International Student Services

University of Central Oklahoma

Edmond, OK  73034-5209

405-974-2390       Fax: 405-974-3842

 

INTERNATIONAL TRANSFER RELEASE FORM

 

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 to attend by the Student & Exchange Visitors Program of US Department of Homeland Security (DHS).

 

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 on SEVIS until notified of admission by UCO International 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 this student pursuing a full course of study and in good standing with DHS therefore eligible to transfer?    ___Yes   ___No
explain: _______________________________________________________________

 

Is this student in good academic standing?  ___Yes   ___No, explain: _____________________________

 

Is this student in good financial standing?   ___Yes   ___No, explain: _____________________________

 

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

  If yes, briefly explain on the back of this form.

 

_____________________________________________________________________________________

Signature                                                                               Name and Title of Official                                                   Date

 

_____________________________________________________________________________________

            Institution Name and Address (or please enclose your business card)                                     E-mail Address

 

(INSTITUTIONAL SEAL)