Fall Quarter Plan 2014
IEP Level
Must be returned to the IP Office by September 12
Failure to turn in on time could affect your Immigration status
If you change your plans, you will need to complete an updated form and submit it to the IP office
Student ID:
Family Name:
Given Name:
Date of Birth:
Phone number (cell):
Phone number (home):
Gender: (circle one)
First Language:
Visa type: (circle one)
Male
Female
F1
F2
J
other
Email address:
 Take a Quarter Off: You are required to leave the U.S. (You MUST provide a copy of your
roundtrip plane ticket with dates and bring your I-20 and passport to the IP office for signatures)
 Take a Vacation Quarter in the U.S. (Sept 22 – Dec 10) I have studied full-time for 3 previous
quarters. You will receive an approval email from an advisor___________________________________
 I am transferring to another college/university Name of College: _______________________
Reasons for transferring: ___________________(Turn in an Acceptance Letter from you new
school and fill out a Transfer-Out Form)
 I will return home and not continue study at NSCC Reason: __________________________
(You MUST provide copy of your plane ticket.
Student signature: __________________________________
Date: ____________
ADVISOR NOTES:
______________________________
GPA_______________
AP_____________
JUMPER _______________
COMPASS YES
NO
Placement______________________
updated 08/18/2014