Attention advisors: please email (firstname.lastname@example.org) or fax (903.415.2560) this form to the GCC International student office.
Transfer Clearance Form
This portion to be filled out by the student
Student’s Name __________________________________________________________
Last First Middle
SEVIS I-20 ID# __________________________________________
I give permission to my present school to release the information requested on this form.
Student’s Signature Date
This portion to be filled out by the Designated School Official
SEVIS record to be released upon proof of acceptance. Anticipated release date_______
Please mark all statements that are true about this student:
_____ Student is currently in good standing and is eligible to transfer.
_____ The student has cleared all financial obligations with our institution.
_____ Student is on academic probation or suspension.
_____ Student is on OPT. Expiration date________________
Students who are out of status or on suspension/dismissal are not eligible to transfer. Please do not transfer student.
Signature of DSO Name and Title of DSO Date
Name and address of institution
Phone Fax E-mail
Grayson County College
6101 Grayson Dr.
Denison TX 75020-8299
(903) 463-8749 FAX (903) 415-2560