Extension request form
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This document is an application for an F-1 student visa extension. It contains sections for information about the student such as name, SEVIS number, address, and required financial documentation. It also contains a section for the student's academic advisor to provide details on the student's academic program and progress, including the reason an extension is needed and the expected completion date. The advisor must sign off on the application along with their contact information.
Extension request form
- 1. Application for F-1 Extension of Stay Section A. (To be completed by student) Date: __________________ Student Name: ___________________________, ___________________________ ________ Last First Middle Initial SEVIS #: N __ __ __ __ __ __ __ __ __ __ Banner #: V __ __ __ - __ __ - __ __ __ Current Address: _____________________________________________________________________ Number, street apt. City State ZIP Code Birthdate: ______________ E-mail: _________________@vcu.edu Phone: __________________ Attach appropriate bank statements to prove required funding. (These statements must be either on official bank letterhead paper or signed by a bank official.) Section B. (To be completed by academic adviser) Academic Program: ___________________________________ Degree level: __________________ 1. Reason that extension is required: _____________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 2. Briefly describe student’s academic progress: ____________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 3. Number of credits still required to graduate: __________________ 4. Expected completion date for all requirements of academic program: __________________ mm/dd/yyyy Academic adviser name: ____________________________ Phone: __________________________ E-mail address: ______________________________ Department: ___________________________ Academic adviser signature: ________________________________ Date: ____________________ Updated 2010 Global Education Office - Immigration Services 817 W. Franklin Street, P.O. Box 843043, Richmond, VA 23284 Tel: (804) 828-0595 Fax: (804) 828-2552