Transfer Form - University Of Colorado Denver

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Campus Box A005/185
P.O Box 173364
1380 Lawrence Street, Suite 932
Denver, CO 80217-3364
Office of International Affairs
Office:
303.315.2230
International Student & Scholar Services
Fax:
303.315.2246
Transfer Form
Please complete the information in Section I and submit this form to your International Student Advisor at your
present/last school.
SECTION I: To be completed by the Student
____________________________________
_____________________________
___________________
Last/Family Name
First Name
Middle Name
____________________________________
_____________________________
___________________
Country of Citizenship
Date of Birth MM/DD/YYYY
Immigration Status
My intended SEVIS release date is ____________________________________.
Please note that this date can be changed until the specified date.
Start date of semester that I will attend at the University of Colorado Denver __________________________.
I hereby authorize the International Student Advisor or DSO to provide the information below as part of
my request to transfer to CU Denver.
Date: ______________________________
Signature: ______________________________
SECTION II: To be Completed by International Student Advisor or DSO
SEVIS Number _________________________ Program completion date on I-20 or DS-2019 ________________
Do not release student’s SEVIS record if CU Denver semester start date listed in section above is 5+ months after
last date of enrollment at your institution.
School Code for F-1: DEN214F00301000 School Code for J-1 program: P-1-03858
Please check all that apply
This student is in good standing and is/was enrolled in a full course of study until (date) __________________.
This student is out of status and a reinstatement was filed on (date)____________________ and is pending.
This student is out of status and must file for a reinstatement; student
has or
has not been advised.
This student is on Practical/Academic Training. Beginning date ____________ Ending date ______________
Other comments: __________________________________________________________________________
__________________________
________________________________________
DSO/ARO Signature
Name of DSO/ARO
__________________________
_______________________________________
____________
Title of DSO/ARO
Name of School
Date
__________________________
_______________________________________
____________
School Address
Email Address
Telephone
Please E-mail a scanned copy of the form to ISSS@ucdenver.edu.
DO NOT FAX. Thank you.

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