Transfer-In Verification Form For F-1 Students
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1Transfer-in Verification Form
for F-1 students
This form is required for all international students admitted to a full-time program at Northeastern University and who
are currently enrolled or are in a period of post-completion Optional Practical Training at another U.S. school.
Important: Your I-20 from Northeastern cannot be issued until this form is complete AND the SEVIS record release
date listed below has passed.
Part I
: to be completed by the student requesting a transfer of his/her SEVIS record to Northeastern
Student’s Name: ________________________________________________________ DOB: _____/_____/_____
(Given Name)
(Family Name)
(mm/dd/yyyy)
SEVIS ID: ______________________ ____
Admitted to Northeastern University at:
Boston Campus
Seattle Campus
Start date of the program that you intend to enroll at Northeastern University: ________/_______/________
By signing this form, I authorize to complete Part II of this form and release my SEVIS record to Northeastern
University. (Please note: your OPT employment authorization ends on the date your SEVIS record is released).
Student’s signature ____________________________________________________Date:_____________________
Part II
: to be completed by an International Student Advisor (P/DSO) at the current school.
Name of your Institution: ______________________________________________________________________
What was the date/will be the last date of enrollment at your school? ___________________
Never attended
Has the student been authorized for post completion OPT?
Yes
No
If yes, list any periods of OPT: ________________________________________________________________
To the best of your knowledge, is the student in status and eligible to transfer to Northeastern?
Yes
No
If no, please explain: ___________________________________________________________________________
/
/
(
): _______
_______
________
SEVIS record Release Date*
please specify a date
*Please do NOT complete or terminate the SEVIS record if the student is eligible to transfer.
Northeastern School code: Boston Campus - BOS 214F00257000 / Seattle Campus - BOS 214F00257002
P/DSO Name and Title: ___________________________________________________________________________
Please Print
Signature of P/DSO : _________________________________
Contact info: _______________________________
Once this form is complete, please return it to the student. The student will
need to submit this form along with other documents to Northeastern.
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