International Student and Exchange Visitor Departure Notice

  • Current International Student and Scholar Departure Notice
  • Complete

Occasionally, and for a variety of reasons, students and scholars leave the University early or unexpectedly. Some of these reasons include early graduation, leave of absence, suspension, expulsion, or family emergencies. You are required to inform the Office of International Affairs if you plan to leave the University before the date on your immigration document (I-20 or DS-2019) and provide the reason for doing so. You can do this by completing this form and returning it to our office prior to your departure. This form should not be used for summer vacations or school breaks.

Name
Academic Status
Immigration Status
May we give your forwarding address to others who inquire?
What are your future plans?
Will you change your visa status?
Will you transfer your current visa status to the new institution?
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