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International Student Transfer Recommendation for F-L and J-L students

To be completed by Student:

l"l H t{'TA S*HSL KqWAR tryK.r


Last Name First Name Date of Birth

I intend to transfer to: for the following semester/year: or UB:ELI term:


\y'University of Bridgeport (BOS214F10145.000) trrSpring 2OI_
tr University of Bridgeport: English Language lnstitute (BOS214F10145.001) fsummer ZOLL write in month
e University of Bridgeport Stamford Center (8OS214F1A145.002) tr Fall 201 you wish to start
at UB: ELI
I hereby grant permission for the information requested below to be made available to the University of Bridgeport.

student's signarure, S. $' IvJg'l-$5 Dare ,3 tf I f 9l fiu J-r.

Please submit this form to your cunent Foreign Student Advisor fs1 6smFletion.
Please note: students in J-l status should contact the International Offrce directly for information on school transfer. The J
program number for the University of Bridgeport is P-1-03391.

To be Completed bv the Desimated School Official:


The above named student intends 16 6ensfer to the University of Bridgeport campus specified above for the semester stated above.
Please use the back of this page as needed for any additional comrnents. Return to: International Student Services, University of
Bridgeport, 126Park Avenue, G-level, Bridgeport, CT 06604 or fax (203) 576-446L.

1. Non-immigrantsrarus: f 'I n. l)W/7OFfg


sEvrs Release a^n,
#//
2. Dares of acrual anend*" cf * #7*&)ft'>to p rf #ft*

3. Has the student maintained legal status with USCIS? yesR noI
4. Is the sfudent eligible to continu e at your school? yesflr noE
If no, why not?

5. If in F-l status, has the student used any periods of CPT or OPT? yesn noFr
If yes: specify dates, part time/full time, type and degree level

6. Has the sfudent had authorLzation for a Reduced Course Load? yesFF nou
If yeq: please spEcify,category, degree levgl and dates authorized
'lQ/tt 4a q(aErtt JmnrvtEtrq {(fiur<plts?irp! ,r3/,
ft!4sf6,4?s
7, Has the student fulfilled his/her financial obligations? yesx noI
8. If in J-1 stafus, what is the Exchange Visitor's category:

Has the Exchange Visitor used any periods of Academic Training: yes n noE
If yes, from to_ _
T ort the transfer request?

Name: / Title: Sf?rfi'f /


Signatur Date:

Institution: Tel :

Mn/.#

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