THE GRADUATE SCHOOL

NORTH CAROLINA STATE UNIVERSITY

102 MAIN CAMPUS DRIVE
ROOM 2300, TEXTILES BUILDING
CAMPUS BOX 7102
RALEIGH, NC 27695-7102
FAX (919) 513-0570
ckhester@ncsu.edu

VISA CLEARANCE FORM

TO BE COMPLETED BY INTERNATIONAL APPLICANTS CURRENTLY IN THE UNITED STATES IN F-1, J-1 or OPT STATUS

SECTION I: TO BE COMPLETED BY ALL APPLICANTS

NAME/ Date of Birth: _______________________________________________________________________________________
(SURNAME ) (GIVEN NAME) (DOB:mm/dd/yyyy)

9 digit NCSU Student ID #: ___________________________ SEMESTER OF INTENDED ENROLLMENT: ________________

IF YOU ARE CURRENTLY IN F-1 OR J-1 STATUS, DO YOU PLAN TO LEAVE THE US PRIOR TO BEGINNING YOUR
STUDIES AT NC STATE? ____ NO ____ YES DATE OF ANTICIPATED DEPARTURE: _________________________

SECTION II: TO BE COMPLETED BY THE J-1 RESPONSIBLE OFFICER/ALTERNATE RESPONSIBLE

OFFICER OR F-1 DESIGNATED SCHOOL OFFICIAL OF YOUR CURRENT PROGRAM SPONSOR

SEVIS TRANSFER RELEASE DATE: __________________________

IS THE STUDENT IN LAWFUL J-1 or F-1 STATUS AND ELIGIBLE TO TRANSFER? _____ YES _____ NO
IF NO, PLEASE EXPLAIN:

Is the student currently attending the school he/she was last authorized to attend? ______ YES ______ NO
If no, please explain:

Program Level the student has most recently been authorized to pursue: _____________________________________________

Please provide number of months used and dates of authorized Practical Training and specify whether full-time or part-time):

Curricular Practical Training: ________________________________

Optional Practical Training : ________________________________

(Please attach copies of EAD if available)

__________________________________ _____________________________________________ _______________

Signature of School Official Name and Title of Official Date

______________________________________________________________________________
Name and Address of Institution

Phone: ____________________ Fax: __________________________ E-mail:_______________________________________

Student, in order to facilitate your transfer process, upload the following to your NCSU online application:
1. Visa Clearance Form
2. Certificate of Financial Responsibility
3. I-20/DS-2010
4. I-94 electronic print out
5. Visa (and/or any recent receipt/approval notices from USCIS)
6. Passport biographical pages
7. If you are an F-1 student who is currently on or has completed Optional Practical Training, please include a
copy of your Employment Authorization Document (EAD card)

All documents should be uploaded at the same time. Partial uploads will be deleted after one week. Use your PIN and
password at http://www.ncsu.edu/applygrad to upload in the International Applicants Only section.