F-1 Student Withdrawal Request Form : International Student and Scholar Services (ISSS) : Texas State University

Do not complete this request if you are not a student on an F-1 visa.

This form is not intended for domestic students.

Prior to completing this form you should consult with a DSO.

Schedule an appointment using the online appointment system or call 512-245-7966.

Last Name *

First Name *

Student's SEVIS Number (enter: 'None' if you do not have a SEVIS ID number) *

Student's Texas State ID (Begins with "A") *

Student's Texas State Email Address *

Student's Phone Number *

First Semester At Texas State (example, Spring 2022) *

Semester Requesting Withdrawal (example, Spring 2022) *

Select Your Student Level *

Undergraduate

Graduate

Please provide a detailed reason for your withdrawal request. *

Acknowledgements: *

I understand that by withdrawing from the university my SEVIS record may be terminated. (Not applicable to continuing students withdrawing from a summer term)

I understand that if my SEVIS record is terminated I am responsible for departing the US within 15 days of the termination date.

I understand that if I return to Texas State University on an initial F-1 SEVIS record for a future term, I must be enrolled full time for a full academic year before becoming eligible for off-campus work authorization, such as Curricular Practical Training (CPT) or Optional Practical Training (OPT).

I understand that if I am not enrolled one long semester (fall or spring) and plan to return to Texas State I may be required to submit a new application. Refer to Undergraduate Admissions or the Graduate College for more information on readmission processes and deadlines.

I understand that the termination of my F-1 record will result in the loss of legal status for any F-2 dependents active on my record. F-2 dependents in this situation are not allowed to remain the US.

If you happen to see this, do not fill this field.