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In order
to complete your application for admission to West Virginia
University Institute of Technology, your International Student
Advisor should complete this form and return it to:
Office of
International Students
Box 54 Old
Main
West
Virginia University Institute of Technology
Montgomery,
WV 25136
Fax:
304-442-3464 Telephone: 304-442-3143
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TO BE COMPLETED BY THE STUDENT
I grant
permission for the information requested below to be released
to West Virginia University Institute of Technology.
Name
of Student: ______________________________________________________________________________________
(please
print) Surname
(family)
First Middle
Country
of Citizenship: _____________________Email______________
Current
Telephone Number: ______________________
Current U.S. Mailing
Address:_________________________________________________________________________________
Signature:________________________________________________________________________________________________
TO BE COMPLETED BY THE
INTERNATIONAL STUDENT ADVISOR
The
above-named international student has qualified academically
for admission to West Virginia University Institute of
Technology. We therefore request confirmation of his/her
status at your institution before approving transfer to West
Virginia University Institute of Technology.
1. Student's
Current Immigration Status: ________ I-94 Expiration Date ___________ I-94
Admission No.____________________ (please attach copy)
For
F-1 students, completion date on I-20 _____________(please
attach copy)
_____
The student is in good standing and is/has been pursuing a
full course of study (or has already been reinstated to status
by INS).
_____
The student is out of status and a reinstatement to student
status was filed on ___________________at INS District:
________________ and is pending. (Please
enclose copies of documents filed with INS.)
_____
The student is out of status because __________________________________________________________
_____ Other:
_________________________________________________________________________________
2. Dates
of attendance at your school ___________________________________________________________
3. Please
indicate the dates of any practical training in which the
student has participated:
Curricular_______________________ Optional__________________________J-1Academic
______________________
4. Are
you aware of any problems? (Health, financial, other)? Yes
________ No __________
5.
If you are a SEVIS school, please indicate the release date
for
transfer out: ________________
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Signature
of School Official: _________________________________________________Date____________________
Name
and Title of Official :
_________________________________________________________________________
Name
of School: _________________________________________________________________________
Address: _________________________________________________________________________
Telephone
Number:
________________________Fax______________________Email __________________
Note: Sample document DO NOT print.
For
Word document click here.
International Student Services WVU Tech.
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