F-1 Student Travel Request Form

F-1 Student Travel Request Form

Purpose

This form is intended for students who plan to travel outside of the United States for a period in which they will not miss classes. If extenuating circumstances require that you leave the country for longer, a leave of absence form must be filled out instead of a travel request form.
Student Information
Name*

First NameLast Name
Student ID #*
SEVIS ID (Found on I-20 or DS-2019)*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Phone Number*

Area CodePhone Number
Country of Citizenship*
Passport Expiration Date*

MonthDayYear
Current Student?*

YesNo
Travel Information
Attendance is mandatory for all on-campus courses at ITU. The university requires all of its students to attend, fully participate, and be engaged in all of the courses in which they are enrolled each term. However, in the event that students miss more than 20% of required attendance on campus, students will be administratively withdrawn from the course and receive a grade of unauthorized withdrawal (UW).
Are you currently enrolled at ITU?

YesNo (On OPT/STEM)On approved F-1 Annual Vacation
Will you be missing classes?

YES (If yes, you must get approval from Registrar's Office, otherwise you risk being dropped from your course)NO
Reason for Travel*
Write a brief description
Will you visit Canada or Mexico?*

YesNo
Which country will you be travelling to?*
Estimated Departure Date*

MonthDayYear
Estimated Return Date*

MonthDayYear
Do you plan to renew your visa while on this trip?*

YesNo
Visa Information
Current Visa Type*
Authorized for multiple entries?

YesNo
Visa Expiration Date

MonthDayYear
Students with the Form I-797A
Write D/S (if you have Form I-797A with F-1 status)
Do you have a pending application with USCIS?*

YesNo
If you have a pending application with USCIS, they will interpret your departure as you abandoning your application. USCIS will deny your pending application.
Signature*
Date*

MonthDayYear
Should be Empty:

F-1 Student Travel Request Form

Student Information

Travel Information

Visa Information