SP16-Change of Program Student Form Type 5-20150825

Directions

You are an ITU student. You are changing your degree program.

Please fill out all of the following information and attach all of the requested documents. Remember that the asterisk (*) next to a field means that it is required.

For efficient processing of your request, please:

Submit all documents in English or with a true English translation made from the original document written in the foreign language. This can be done either by a professional translation done through a licensed translation service, or can be done by someone who is competent in both the foreign language and in English. In the case of the latter, the person should certify this with the following language:
- "I certify that I am competent to read and translate in and in English, and I certify that the translation performed above is a true translation taken from the original document written in." NAME, ADDRESS, DATE
Submit all documents in PDF format.
Include your ITU Student ID Number in the title of all submitted documents

Please provide your full name as it appears in your passport.

Lead Source

Lead Status

Surname/Primary Name *

Given Name

Student ID Number

Date of Birth *

Month Day Year

Gender *

Female Male

Country of Birth *

Country of Citizenship *

E-mail Address *

Permanent Address Outside U.S. *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Local Address in U.S. *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Phone Outside the U.S. *

Please include your country code.

Phone Within the U.S. *

Area Code Phone Number

Term You Changed Programs *

Previous Program of Study *

New Program of Study *

Current Visa type *

F-2 H-4 H-1B H-3 B-1 B-2 J-1 L-1 Other

Other Visa type

Name of Last Designated School Official who signed your most recent I-20

Are you currently a student at ITU? *

Yes No

Please return to the ISO Submission Form and select a student type that better matches your current status.

Upload Copy of Your Passport *

Please include the first page, signature page, and any other informational page.

Upload Copy of Your Current U.S. Visa or I-797A *

Upload I-94 *

Do you have any dependents who are or will be joining you in the U.S. and need an F-2 I-20? *

Yes No

If your dependents are not already added on your SEVIS record, please submit the F-2 Request Form and submit a request through the ITU Support Ticket System to the International Student Office.

Mail Preference *

Regular Mail Express (Domestic) DHL (International) Pick Up

Mailing Address

Signature

Change of Program Student Form (Student Type 5)