KALAMAZOO VALLEY COMMUNITY COLLEGE
INTERNATIONAL STUDENT
F-1 TRANSFER FORM

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All applicants presently in an F-1 immigration status applying to Kalamazoo Valley Community College must present this form for completion by your last authorized school. The Designated School Official must answer the following questions before your application to KVCC can be reviewed.
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NAME OF APPLICANT (as it appears on official documents)                     STUDENT IDENTIFICATION #__________________

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Family name/Surname/Last name                                                 First name

ADMISSION NUMBER ________________________ PROGRAM OF STUDY____________________________
                                  (from I-94, if known)

I authorize the DSO at the school currently maintaining my I-20 to release any record-keeping information needed to Kalamazoo Valley Community College.

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Signature of Applicant                                                                                         Date
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NAME AND ADDRESS OF SCHOOL CURRENTLY ISSUING THE I-20
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School Name
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Number Street
______________________________         __________________________         ______________________
City                                                                     State                                                     Zip/Postal Code

__________________________         _______________________         ______________________________
Phone Number                                         Fax Number                                        E-Mail Address

SCHOOL INS FILE # ________________________________

LAST TERM STUDENT WAS ENROLLED AT YOUR INSTITUTION _____________________________________

DID THE STUDENT MAINTAIN LAWFUL STATUS? ______ Yes ______ No

If no, reason ______________________________________________________________________________________

WAS THE STUDENT AUTHORIZED FOR OPTIONAL PRACTICAL TRAINING? ______ Yes ______ No

WAS THE STUDENT AUTHORIZED FOR CURRICULAR TRAINING? ______ Yes ______ No

IF YES, FOR HOW LONG? _____________________   Full Time Part Time

Print Name of Designated School Official
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Signature of Designated School Official                                                                                                     Date

Revised July 1998
Admissions, Registration and Records Office