INTERNATIONAL
STUDENT ACADEMIC STATUS REPORT
INTERNATIONAL STUDENT SERVICES
Box 54 Old Main *304-442-3143

To Undergraduate
Chairs, Academic Advisors, and Graduate Program Director
From Anne K. Repaire,
Director, International Student Services
Re Enrollment
Status of an International Student
Your assistance is requested in
evaluating an international student's eligibility to register
for or drop below a full time credit load and to document
compliance with the Student/Exchange Information Visitor
System (SEVIS), the immigration data tracking program.
Please complete all sections below. Only Section 1 of this
form should be completed by the student him/herself.
I.
GENERAL INFORMATION – to be completed by
the student
Student's
Name____________________________________________________________
Student's
ID#
________________Student's e-mail address
_________________
Student's
Address_____________________________________
________________________
Student's
Telephone __________________________
undergraduate student_____ graduate student____
Student's Major _____________________
ALL
STUDENTS, PLEASE NOTE:
·
Students taking a reduced course load for
medical or 1st-semester academic difficulty reasons
may not engage in employment during the applicable
semester(s).
·
Students experiencing language difficulties may
be required to enroll in at least one English language class
or take other appropriate action
·
Students taking a reduced credit load may lose
eligibility for on-campus housing and must check with the
Residence Life Office to determine their eligibility to remain
in university housing.
·
Prior to requesting advisor/chair/graduate
program director certification of this form, students should
review conditions and restrictions for each exception category
to ensure their eligibility.
II
STUDENT'S CURRENT ACADEMIC STATUS/ANTICIPATED
ACADEMIC PROGRESS – to be completed by academic chair
or graduate program director
Regulations
stipulate that all F-1 students make "normal progress" towards
their degree at all times.
A.
Is the student named on the top of this form considered
to be making "normal progress" towards his/her degree (progressing at
the rate expected of all students in the student's program?)
Yes_______
No
(explain)________________________________________________________________
B. Based on "normal academic progress" in this
student's program, please provide information on when this
student reached or
is reasonably expected to reach the following stages of
his/her academic program as
noted:
·Completion of all coursework for the degree:
(semester/year) _____________
·Completion of all degree requirements (including
defense, where applicable): (semester/year) _________
·Receipt of diploma dated (month/year)
___________________
(Please see reverse side for
advisor/chair/graduate program director's certification of
reason for reduced credit load)
III.
REASON FOR REDUCED CREDIT OR COURSE LOAD (CHECK
ONE) - to be completed by chair or graduate director
Regulations
stipulate that all F-1students must be enrolled full time (12
credits for most
students) at all times unless they meet one of the regulatory
exceptions to this requirement.
As academic advisor, chair,
or
graduate program director, I certify that I have checked
the appropriate regulatory exception below for this student's
reduced credit or course load and have noted the applicable
conditions for that reason:
_______ MEDICAL
CONDITION –
Regulatory conditions and restrictions for this exception:
·
Permitted for
maximum of 12 months while student is pursuing any one degree
program level
·
Must be certified
in writing by a physician (M.D.), doctor of osteopathy (D.O.)
or licensed clinical psychologist;
·
Must submit a new
form every semester needed;
·
May not be
employed on- or off-campus during semesters authorized for
medically-necessitated reduced credits
________ ACADEMIC
DIFFICULTIES
(choose ONE reason) – Regulatory conditions and
restrictions for this
exception:
·
Permitted
only one semester per degree program level;
· May not be
employed on- or
off-campus during first semester in U.S., if approved for
reduced credits in that semester;
·
Must fall into
one of the four categories listed below (please check
ONLY ONE)
____ Initial difficulty with the English language (first semester
in U.S. only)
____ Initial difficulty with reading requirements (first semester
in U.S. only)
____ Unfamiliarity with U.S. teaching methods (first semester in
U.S. only)
____ Improper course level placement (at any point while
student pursues current degree program level)
COMPLETION OF COURSE OF STUDY (OR COURSEWORK, FOR
CERTAIN
GRADUATE STUDENTS -
Regulatory
conditions and restrictions for this exception:
·
Must fall into
one of the two categories listed below (please check ONLY
ONE)
____ Master's
students who have completed all coursework and are now engaged
in thesis research (permitted for a maximum of 2 semesters,
barring exceptional circumstances):
____ Undergraduate
student in final term of studies
Please
note the risk a student takes in using the "final term only"
exception: once the INS is
notified of this reason,
if the student subsequently is unable to complete studies by
the end of the
applicable term, he/she will automatically
be considered "out of status" by the INS and will have to apply
to the INS for "reinstatement" to status to continue
studies. When applying for "reinstatement," the student
will have to convince the INS that
his/her inability to complete in the expected semester does
NOT constitute failure
to meet the requirement
of "making normal progress" towards the degree. If
the recommendation is for any reason other
than one of the three specified above, the chair/graduate program
director
should NOT complete this form, but should
instead consult Anne Repaire, International Student Services,
(442-3143).
IV.
SEMESTER TO WHICH THIS
FORM APPLIES – to be
completed by the chair, academic advisor, or
graduate
director
Fall or
Spring Year: __________ (only one semester per
form)
Number
of credits student will take in the semester noted above
_________
Number
of credits that will remain for degree completion after the
semester in
question ________
V.
ADVISOR/CHAIR/GRADUATE
PROGRAM DIRECTOR
CERTIFICATION AND CONTACT
INFORMATION
I certify that all information
provided on this form is accurate to the best of my knowledge
and judgment.
Advisor/Chair/Graduate
Program Director Name________________________
Program
___________________
Signature
__________________________________________Telephone
_________________________
Note: Sample document DO NOT print.
For Word document click
here.
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