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I-20/DS2019 TRAVEL SIGNATURE REQUEST

Please answer the following questions before dropping off your I-20 or DS2019 for travel signature.

Last Name:

First name:

CWID:

(no dash)

Major:

Please Note: If your current major is different from what is printed on your I-20 or DS2019, you need to request a new one BEFORE traveling outside the U.S.

Email:

Phone#:

(XXX-XXX-XXXX)

Current U.S. Address:
(NO P.O. Box allowed)

City:

State:

Zip Code:

Estimated Departure Date:

Estimated Return Date:

Destination(country):

Current Status (please check appropriate box): F1F2J1J2F1 on OPT (please attach copy of EAD)

FOR F-1 STUDENTS ON APPROVED OPT ONLY: You must complete the Online OPT Employer Information Form BEFORE this Travel Signature Request can be processed. Please ask the front desk staff to assist you with completion of the update form. You may complete it at the front desk computer.

In order to keep our files up to date, please provide us with a copy of the following:
(without these copies/dates, your request may NOT get processed)


Passport Expiration Date:		F-1 or J-1 Visa Stamp Expiration Date:

If your visa has expired, please specify the country where you plan to apply for your visa:

Special Attention: If you have applied for Reinstatement to F-1 status,
please see an advisor before traveling.

REQUIRED: Emergency Contact in the United States

Last Name:

First Name:

Email Address:

Relation to you:

FriendRelative

Cell Phone#:

Daytime Phone#:

REQUIRED: Emergency Contact at your Destination (outside U.S.) [Please write in English]

Last Name:

First Name:

Email Address:

Relation to you:

FriendRelative

Phone#:

(please include country code)

Fax#:

(please include country code)

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