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WORK & TRAVEL PROOF OF STUDENT STATUS

To be completed by an official College/University Representative. This document must be

completed in full. Any documents with missing information will not be accepted.

This document is to certify that the following student is registered in your college/university in good
standing as a full time student for the current academic year as well as to verify the
college/university official summer break dates.

Student Name: __________________________________________________________________________

College/University Information:
Name: ________________________________________________________________
Address: ______________________________________________________________________________
City: _______________________ Postal Code: _____________ Country: _________________________
Phone number: __________________________ Fax number: __________________________________
Website: _____________________________________

The official college/university’s summer break is:

Month: _______ Date: ________ Year: _____ until Month: ________ Date: _________ Year: _____

Name of School Representative Completing Form ____________________________________________

Job Title ____________________________________________________

Email address ________________________________________________

Signature ____________________________________________________

Date ______________________________

University Seal/Stamp

55 New Orleans Road 210 Fountain Center, Hilton Head Island, South Carolina 29928
web: www.ieexchanges.com Phone: 001-843-785-1963 Fax: 001-803-783-9322