F-1 INTERNATIONAL STUDENT ADVISOR REPORT FORM

Dear Prospective Student,

To complete your transfer application to Houston Community College and issue you the SEVIS I-20 form, we must have an
F-1 International Student Advisor’s Report form completed by the institution you are currently attending. Your signature
serves as authorization for information to be released to HCC.

____________________________________________________________________ ____________________________
Student’s last name First name Middle Name Country of Citizenship

________________________________ ________________________________ ____________________________

Students Signature HCC Student ID Number Date

Designated School Official: Please answer the following questions about the student named above and return form to:

Houston Community College

Student Support Office/ International Student Services
P. O. Box 667517 MC 1138 Phone: 713-718-8521
Houston, TX 77266-7517 Fax: 713-718-2112

1. Type of Visa________ 2. Dates of enrollment: from_______________________ to ______________________________

3. Program of study______________________ 4. Estimated date of completion ___________________________________

5. Is the student currently in legal status with immigration? Yes________ No_________

6. Can student return to your institution? Yes________ No_________

If no, why not?______________________________________________________________________________________

7. Off-campus employment authorization? No ______ Yes ______

If yes, what kind and dates?____________________________________________________________________________
8. Previous authorization for reduce course load? No ______ Yes _______
If Yes, what kind and dates?____________________________________________________________________________
9. Other comments _____________________________________________________________________________________

SEVIS No.: __________________________________________ Date Released: ____________________________

HCC School code: HOU214F00354000
(If student has not submitted proof of acceptance to HCC, a letter of acceptance can be submitted by a HCC DSO
AFTER this form is received)

___________________________________________________ ____________________________________________
Name of Institution Date

___________________________________________________ ____________________________________________
Name of School Official (Please Print) Signature

_________________________________ __________________________________ _______________________________________________________________

Tel. Fax: Email:

Updated: 04/06/2009