Students: Only complete this form if you have determined that you meet the eligibility of a SEVIS transfer. Complete Part I, print the form and submit it to your current international student advisor. You must discuss your transfer-out date with your current advisor. Your advisor should complete Part II and give the form back to you. Once you have a completed Transfer form then you may submit your I-20/DS-2010 Request. Advisors: Northwestern University does not accept completed SEVIS records. If you are transferring a Terminated SEVIS record, please contact our office prior to setting the transfer. *We will not accept Transfer forms without the I-20/DS-2019 Request application.
Part I: To Be Filled-Out by Student: Type your name EXACTLY as it appears on your passport:
Name: (Last Name) (First Name) (Middle Name)
Use an e-mail address that will be valid through your arrival at Northwestern:
Email: Date you expect to begin at Northwestern: Date of Birth: (mm/dd/yyyy) (mm/dd/yyyy) EMPL ID (Student ID):
Program at NU: Part II: To Be Filled-Out by Current International Student Advisor (in pen ink):
What is the student's current status in SEVIS?: SEVIS transfer-out date: Student's date of initial entry to the U.S.: SEVIS ID number: Current level of study: Date of graduation or completion of study: List any periods of Practical or Academic Training: OPT _________________________________________________________________________________ AT Institution Name: School SEVIS Code: Name of PDSO/DSO or RO/ARO completing this form: Phone: Northwestern's SEVIS School Code is CHI214F01109000. PDSO/DSO or RO/ ARO Signature: The International Office - Northwestern University 630 Dartmouth Place, Evanston, IL 60208 Tel: 847-491-5613 Email: intadmit@northwestern.edu Date: E-mail: _________________________________________________________________________________
Updated 03/2013