116 Allen Hall • P.O. Box 9742 • Mississippi State, MS 39762 Phone: 662-325-8929 • Fax: 662-325-4242 •

Email: international@msstate.edu School Code: NOL214F10163000

F-1 SEVIS Transfer-In Form

STUDENT INFORMATION: (to be completed by student)

Name: __________________________________________________________ (LAST/FAMILY) (First) (Middle)

Date of Birth: _____________________ Current School:______________________________ (MM/DD/YYYY)

Semester Applying for: FALL SPRING SUMMER Year: 20____ (select one)

Will you leave the U.S. before enrolling at Mississippi State? Yes No If yes, please go to #1. If no, please go to #2.

1) Please mail my transfer I-20 to the following address after my release date:

___________________________________________________________

____________________________________________________________

Telephone: _________________________ Current E-mail: _______________________________

2) ____ (check here) I will NOT be traveling abroad. I will pick up my I-20 in 100 Montgomery Hall when Iarrive on campus.

Please return to the Office of Admissions and Scholarships International Services team by fax or traditional mail. Contact information is at the bottom of the form.

SEVIS INFORMATION: (to be completed by DSO)

Has the student maintained valid F-1 Visa Status? Yes No

Has student been granted any period of Practical Training? Yes No

If yes, what type & dates __________________________________________________________

Student’s Transfer Release Date: _______________ SEVIS ID: ___________________

___ (check here) I confirm that, to the best of my knowledge, the student named above has continually maintained F-1 status, has been enrolled in a full course of study, and is eligible for an F-1 Transfer.

Name and Title__________________________________________________________

DSO signature: ____________________________________ Date: _______________

Email: _____________________________________ Telephone: ________________