INTERNATIONAL STUDENT TRANSFER-IN FORM
Complete only if you will transfer to Converse University from another
university, college, language school, or high school in the United States.
Section A. To be completed by the admitted student.
Family (Last) Name: _____________ First Name (given name): _____________
Current U.S. Address: _____________________________________________
Email Address: _________________________________________________
Will you travel outside of the U.S. prior to attending Converse University?
Yes No
If yes, when will you depart, or when did you depart the U.S.? _____________
What is your anticipated arrival date to the U.S.? ______________________
What is the expiration date on your F-1 visa? _________________________
By signing below, I grant permission for the information provided on this form to be
forwarded to Converse University.
_______________________________ _______________________
Student Signature Date (MM/DD/YYYY)
Section B. To be completed by the International Student Advisors at the student’s
current institution (P/DSO):
The F-1 Program School Code for Converse University is ATL214F01409000.
SEVIS ID: N00______________ Expiration Date of I-2/DS2020: _____________
SEVIS Record Transfer Release Date: __________________________________
Name and Address of Your Institution: _________________________________
P/DSO contact phone number and email: _______________________________
Is/was the student pursuing a full course of study? Yes No
Degree/Major: __________________________________________________
Dates of attendance at your institution: ___________________ to ____________
Is the student in status according to Immigration Regulations & eligible to transfer?
Yes No
If no, please explain: _________________________________________
Has the student ever applied for Optional Practical Training (OPT) or Curricular
Practical Training (CPT)? Yes No
If yes, indicate all authorization: CPT OPT _________ to _________
MM/DD/YYYY MM/DD/YYYY
Section C. Signature of International Student Advisor (P/DSO):
_________________________ ______________________ ____________
P/DSO Signature Name and Title (Please Print) Date (MM/DD/YYYY)
Please scan and return this form, along with copies of ALL forms-
I-20/DS/2020, U.S. visa, Passport Information Page, Declaration of
Finance, language test scores (TOEFL), NACES accredited evaluation, and
Paper Form I-94 (front and back) OR Electronic Form I-94 (accessible from
www.cbp.gov/I94) via email to the Office of Admissions at
