Form 1-17 - Petition For Approval Of School For Attendance By Nonimmigrant Student Page 11

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Execution of Petition
If the school is approved, The Petitioner Agrees:
1.
Upon acceptance of any nonimmigrant alien student, to furnish that student a Certificate of Eligibility, Form I-20A/B for
an F-1 student, or Form I-20M/N for an M-1 student.
2.
To keep records containing the following specific information and documents relating to each nonimmigrant F-1 or M-1
student to whom the school issues a Form I-20A/B or I-20M/N, while the student is attending the school and until the
school notifies the INS in accordance with regulations at 8 CFR 214.3, that the student is no longer pursuing a full course
of study. The school must keep a record of having complied with the reporting requirements for at least one year. If a
student out of status is restored to status, the school that enrolled the student must maintain these records following
receipt of notification from the INS that the student's status has been restored. The school must keep and, upon request,
make available to the INS the following information and documents for each nonimmigrant F-1 and/or M-1 student:
a.
Name.
Date and place of birth.
b.
Country of citizenship.
c.
Address
d.
e.
Status, i.e., full-time or part-time.
Date of commencement of studies.
f.
g.
Degree program and field of study.
Whether the student has been certified for practical training and the
h.
beginning and ending dates of certification.
i.
Termination date and reason, if known.
j.
ocuments referred to in paragraph 212.3(k) regarding the Certificate of Eligibility.
D
k.
umber of credits completed each semester.
N
l.
Photocopy of the student's I-20 ID Copy.
That in any advertisement, catalogue, brochure, literature or other material produced by or for this school, any statement
3.
that may appear concerning approval for admittance by nonimmigrant students must be limited to the following: "This
school is authorized under Federal law to enroll nonimmigrant students."
I certify that I am authorized to execute this petition. I understand that unless this institution fully complies with all terms as
described on this form, approval may be withdrawn pursuant to 8 CFR 214.4.
Dated at:
day of
, this
,
Signature:
Name and Title:
(CORPORATE SEAL
OF INSTITUTION)
Form I-17 ( Rev. 04/05/02)Y Page 3

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