F-1 CHANGE OF LEVEL REQUEST FORM

A. To be completed by student:

Student Name: ___________________________, ___________________________ ________ Last First Middle Initial

SEVIS #: N __ __ __ __ __ __ __ __ __ __ Banner #: V __ __ __ - __ __ - __ __ __

Current Address: _____________________________________________________________________ Number, street apt. City State ZIP Code

Birthdate: ______________ Email: _________________@vcu.edu Phone: __________________ mm/dd/yyyy

Change of level from _________________________ to _________________________ (e.g., from VCU English Language Program to Bachelor’s of Arts)

Are you changing departments? Yes No

If yes, what is the name of your new department? ______________________________

What is the name of your new field of study? ______________________________

What is the current expiration date of your I-20 or DS-2019? ______/______/________ mm dd yyyy

B. To be completed by current ELP and/ or Academic Advisor:

1. Is the student taking ELP classes? Yes No (if No, skip to number 4)

2. If so, when will the student exit the English Language Program? ______/______/________ mm dd yyyy

3. ELP advisor name: _____________________________ _________________________________ Print Signature Date

4. If the student is in an academic program or is taking ELP AND academic classes concurrently, what are the current academic program and degree level:

________________________________________________________________________________

When will this student complete his/ her current academic program? ______/______/________ mm dd yyyy

Academic advisor name: _____________________________________________

Email: _______________________________ Phone: ___________________________

Signature: ______________________________________ Date: __________________ Updated 2010 O f f i c e o f I n t e r n a t i o n a l E d u c a t i o n - I m m i g r a t i o n S e r v i c e s 817 W. Franklin Street, P.O. Box 843043, Richmond, VA 23284 Tel: (804) 828-0595 Fax: (804) 828-2552

Statement of Financial Ability C. To be completed by Student:

Indicate the sources used to support you and your dependents (check all that apply):

Personal/family funds. Provide the name and address of the person providing support:

____________________________________________________________

____________________________________________________________

____________________________________________________________

Departmental funding (e.g., Research Assistant or Teaching assistantship). Please attach your official letter of funding. If additional funding is required (including dependents), you must submit additional financial documentation.

Governmental funding. Attach an official letter which details the source, amount and duration of this funding.

I affirm that I will be responsible for the total costs associated of each year of study at Virginia Commonwealth University, including costs associated with relevant dependents.

____________________________________________ ________________________ Student signature Date

Estimated Expenses* for the 2008-2009 academic year (including tuition for a nine-month term, living expenses, books, and health insurance): Undergraduate $31,724 Graduate (Masters) $30,211 Graduate (Doctoral) $29,893 Add an additional $5,000 to total cost per F-2 dependent.

* Students are strongly advised to use the VCU tuition calculator for differences that may occur in programmatic costs: http://www.enrollment.vcu.edu/accounting/tuition_fees/calculator.html

Please submit this form completed in its entirety with: • original bank statements and/or letters of support from your sponsors, • a copy of your academic acceptance letter