International Student Services

Center for International Students and Scholars (CISS) Request to Extend Completion of Studies Date

International students in F-1 status must show approval by their academic department in order to extend the completion of studies date on their Form I-20. An extension must be requested prior to the expiration date found on page one of the I-20, item #5.

STUDENT: Please complete the top portion of this form and then deliver it to the Academic Advising Office in LaCava. Request an advisor review your record and approve your extension of study time with an expected date of completion.

Please attach a copy of the following to this application: I-20, passport identification and expiration page, F-1 visa and print your I-94 Arrival and Departure Document from cbp.gov/i94 website. Please drop off the completed application to CISS.

After evaluation, a new I-20 will be issued to you reflecting the extended date. **Please note: Updated proof of funding and support letter may be required!**

ACADEMIC ADVISOR: An international student in F-1 status who is “making normal progress toward completing his or her degree, but who is unable to complete his or her course of study” by the expected graduation date, must apply for an Extension of Stay. By filling out the form below, you will help us determine the student’s eligibility for such an extension.

TO BE COMPLETED BY STUDENT

ID#: ______Undergraduate: ______Graduate: ______

Family Name(s): ______Given Name(s): ______

Street Address: ______

City State and Zip Code:______Telephone:______

TO BE COMPLETED BY ACADEMIC SERVICES

Current Semester: ______Degree: __Major(s): ______Minor(s): ______

Current Class Code: ______Number of enrolled credits for current semester: ______

Remaining number of credits to complete degree after current semester:

Expected date of completion: ______

Please check all applicable reasons: ___ Change of major from ______to ______Change in research topic from ______to ______Unexpected research problems ___ Other, please explain: ______

Signature: ______Printed Name: ______Academic Advisor Department: ______Date: ______

(For CISS Office Use Only) Comments: ______Full Time Every Term/RCL: __I -20 end date extended and I-20 printed: ___Updated “end date” in Banner GOAINTL screen: Initials/Date:

Bentley University, Lewis Hall 101, 175 Forest Street, Waltham, MA 02452 Tel: +1.781.891.2829 Fax: +1.781.891.2845 email: [email protected] web: www.bentley.edu/ciss