EXTENSION OF AUTHORIZED PERIOD OF STAY

STUDENTS MUST SUBMIT THIS FORM AND ACCOMPANYING FINANCIAL DOCUMENTATION TO INTERNATIONAL STUDENT SERVICES NOT LESS THAN 15 DAYS PRIOR TO THEIR CURRENT I-20 OR DS-2019 EXPIRATION DATE AND MUST RETURN AGAIN TO INTERNATIONAL STUDENT SERVICES AFTER THE NEW (EXTENSION) I-20 OR DS-2019 HAS BEEN ISSUED BUT BEFORE THE CURRENT I-20 OR DS-2019 HAS EXPIRED

To Department Chairs, Academic Advisors, and Graduate Program Director

From Anne K. Repaire, Foreign Student Advisor

Re Academic Status of an International Student Seeking an Extension of Authorized Stay

Your assistance is requested to evaluate an international student's eligibility to extend his or her authorized period of stay, and to document compliance with the Student/Exchange Visitor Information System (SEVIS), INS's data tracking program. Please complete all sections below as appropriate. Please note: Only Section I of this form should be completed by the student him/herself.

I. GENERAL INFORMATION – to be completed by the student

Student's Name: ___________________________________________________________

Student ID#_______________________ Student's e-mail address: __________________

Student's phone number(s): __________________________________________________

Please underline: undergraduate student graduate student

Student's major:____________________________

F-1 STUDENTS, PLEASE NOTE: The INS does not permit extensions due to delays resulting from academic probation or suspension. Students in this position may be eligible to apply to the INS for reinstatement to F-1 status, but in any case should speak with their Foreign Student Advisor.

II. REASON STUDENT NEEDS EXTENSION BEYOND CURRENT AUTHORIZED PERIOD OF STAY – to be completed by academic chair, advisor, or graduate director

Regulations stipulate students may be granted an extension of stay for "compelling academic or medical reasons, such as changes of major or research topics, unexpected research problems, credits lost in a transfer of schools, or documented illnesses. Delays caused by academic probation or suspension are not acceptable reasons for program extensions." (Note: Medical reasons must also be documented by a licensed medical practitioner if the student has not already submitted such documentation to International Student Services.)

Please explain the "compelling academic or medical reasons" for this student's need for an extension of stay beyond the original program ending date noted on his or her visa document

III. STUDENT'S CURRENT ACADEMIC STATUS/ANTICIPATED ACADEMIC PROGRESS – to be completed by academic chair, advisor, or graduate director

Regulations stipulate that all F-1 and J-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 other students in the same program who might face the same "compelling reasons" you have noted under Part II of this form?)

Yes No If no, please explain below:

B. Please provide information on when this student reached, or is now reasonably expected to reach, each of 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)

_____________

IV. VERIFICATION OF GRADUATE STUDENT FUNDING – to be completed by Graduate

Director

This student has a WVU Tech assistantship or other funding. Please detail:

___ teaching assistantship ___ graduate assistantship ___other (explain)________________

Period of current funding: From ______________to________________*

Stipend for above period: _______________________

Tuition remission: _________ % Fee remission: ____________%

*If current funding ends prior to expected completion of degree requirements, will this

student continue to received WVU Tech funding (barring significant unanticipated

budget cuts)?

___Yes ___No

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 Director Name ____________________________________________

Academic Program______________________________________

Signature ___________________________________Phone Extension ______________

Date ____________________________

Note: Sample document DO NOT print.

For Word document click here.

International Student Services WVU Tech.