ORANGE COUNTY COMMUNITY COLLEGE Office of Admissions INTERNATIONAL TRANSFER FORM Tel: (845) 341-4030 web: www.sunyorange.edu Fax: (845) 342-8662 e-mail: apply@sunyorange.edu Transfer procedure: If you plan to transfer to SUNY Orange from another school within the United States, this form must be completed. This form will provide notification to SUNY Orange of your status at your current school and of your intent to transfer to SUNY Orange. A transfer, according to the U.S.C.I.S (United States Citizenship Immigration Service), is any change of schools, whether you complete your current program and begin a new program at SUNY Orange, or whether you will continue the same degree program here. Please complete the following information and give it to the DSO at your present school. Student Name: Admissions Number (on I-94): Telephone Number: E-Mail: I give permission for my present school to release the information requested on this form: Signature: Date: TO BE COMPLETED BY THE DESIGNATED SCHOOL OFFICIAL This student has been accepted to SUNY Orange. We are listed in SEVIS as �Orange County Community College�, SEVIS code Middletown Campus: NYC214F00636000 and SEVIS code Newburgh Campus: NYC214F00636001. We request confirmation of his/her status before completing a transfer. SEVIS ID#: Date of last attendance at your school: Date current program ends: Release date for transfer out: Has student maintained F-1 status at your institution: ? YES ? NO Please indicate the dates of any practical training in which the student has participated: Name of DSO completing this form (please print) Title of DSO completing this form Signature Date Name of Institution Telephone number Street Address Fax number City, State, Zip Please fax this completed form to SUNY Orange Admissions Office at (845) 342-8662. Rev 09-09-10