INTERNATIONAL STUDENTS AND SCHOLARS - DEPARTURE NOTICE

As required by federal law and in order to maintain accurate records on the international scholar and student populations at UNC, International Student and Scholar Services (ISSS) needs your final departure information. Please fill out the form below and return it to ISSS. This is for final departure only, not for vacations. Thank you for your assistance.

Name: ______(Family/Last) (First) (Middle)

Academic status: ( ) Student ( ) Research scholar or professor (non-student)

Immigration status: ( ) F-1 ( ) J-1 ( ) H-1B ( ) Other, specify: ______

Forwarding address: ______

______

New email address (list email other than UNC address): ______

May we give your forwarding address to others who inquire: ( ) Yes ( ) No

Dates of expected departure: From Chapel Hill ______From the US ______(month/day/year (month/day/year)

What are your future plans?

 Returning to home country. I do not plan to be at UNC-CH.

 Returning to another country. I do not plan to be at UNC-CH next semester.

 Remaining in the United States for Optional Practical Training or Academic Training.

 Remaining in the US: Will you change your visa status? ______Yes ______No * If you will change your visa status, what will be your new visa status? ______

 Remaining in the United States at another employer or institution. Will you transfer your current visa status to the new institution? _____ Yes _____ No

Signature: ______Date: ______

For F-1 or J-1 students requesting a SEVIS transfer to another institution:

1) Have you been accepted to the university in which you are requesting a transfer? ____yes ____ no

2) Have you applied to other schools? _____ yes _____ no If yes, have you made a final decision of which school to transfer to? _____yes _____ no

3) I have given or will give ISSS a transfer form from the new institution, and I am requesting a

SEVIS transfer to ______on ______. (name of new institution) (month/day/year)

I authorize ISSS to contact advisors at the new institutions regarding my transfer.

______(Signature of Student) (Date)

International Student & Scholar Services; CB# 5240; Room 2004 FedEx Global Education Center; UNC-Chapel Hill; Chapel Hill NC, 27599-5240; Tel.: (919) 962-5661; Fax: (919) 962-4282 Attach a copy of the admission letter from the new institution. ISSS will not transfer without proof of admission. Students in valid F-1 status that will begin classes at the new institution within five months of the end of classes at UNC may be eligible for transfer.

Include additional information here: ______

______

International Student & Scholar Services; CB# 5240; Room 2004 FedEx Global Education Center; UNC-Chapel Hill; Chapel Hill NC, 27599-5240; Tel.: (919) 962-5661; Fax: (919) 962-4282