Concordia University Irvine
International Student Transfer Form
This student has applied to Concordia University in Irvine, California. Please complete the transfer form to verify the
student’s status. Thank you for your help in completing this transfer.
Student Name:
Student’s Current Address:
Date of Birth:
Month / Day / Year
Country of Citizenship:
To be completed by Designated School Official:
Name of Institution:
Address:
City, State, Zip:
SEVIS Number :
Dates of attendance:
Release Date:
through:
Passport Expiration Date:
Has this student maintained F-1 status? (If no, please explain)
Is reinstatement needed? (If yes, please explain)
Is this student eligible for transfer? (If no, please explain)
Other comments:
Signature:
Date:
Print Name:
Title:
Phone Number:
Graduate Admission Office
CONCORDIA UNIVERSITY
1530 Concordia West, Irvine, CA 92612-3203
(800) 229-1200 Ext. 1144