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Travel Signature Request
Name
(Required)
First
Last
UALR ID Number
(Required)
Email
(Required)
Enter Email
Confirm Email
Local Physical Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone Number
(Required)
Classification
(Required)
Doctorate
Masters
Undergraduate
IELP
If currently on OPT, use OPT Update form.
Major Area of Study
(Required)
Accounting
Adult Education
Advertising/Public Relations
American Sign Language Studies
Anthropology
Applied Communication Studies
Applied Psychology
Applied Science; also at UACCH-Texarkana
Applied Sciences
Applied Statistics - GC
Architectural & Construction Engineering
Art
Audiology; also at UAMS, UALR consortium
Auditory Based Intervention; also at UAMS
Bioinformatics
Biology
Building Level Administration
Business Administration
Business Analytics
Business Information Systems
Certificate in Accounting
Chemistry
Civil & Construction Engineering
Communication Sciences & Disorders; also at UALR, UAMS, UCA consortium
Computer Programming
Computer Science
Conflict Mediation
Construction Management
Construction Management; also at UACCH-Texarkana
Construction Science
Counselor Education
Crime Scene Investigation
Criminal Justice
Curriculum & Instruction
Curriculum/Program Administration & Supervision
Dance Performance
Data Science
E-Commerce; also at Benton Center
Early Childhood Education
Economics
Educational Administration
Electronic Journalism
Electronics & Computer Engineering Technology
Elementary Education
Engineering Science & Systems
Engineering Technology (Mechanical)
English
Environmental Engineering
Environmental Health Sciences
Finance
General Business; also at UACCH-Texarkana
General Education; also at Benton; Greenbrier High School
Geology
Geospatial Technology
Gerontology
Gifted Education
Gifted, Creative, & Talented Education
Health, Human Performance & Sport Management
Higher Education
History
Information Quality
Information Science
Integrated Computing
Integrated Sciences & Mathematics
Interdisciplinary Studies
International Business
International Studies
Interpretation: American Sign Language/English; also at Tulsa
Law
Law Enforcement
Law Enforcement Administration
Law/Public Service; also at Clinton School
Learning Systems Technology
Literacy Intervention Specialist
Management
Marketing
Marriage & Family Therapy
Mass Communication
Mathematical Sciences
Mathematics
Mathematics Education
Mechanical Engineering Technology
Media Production & Design
Middle Childhood Education
Middle Level Education
Music
Music Education
Nonprofit Management
Nursing
Nursing Completion Program
Orientation & Mobility of the Blind
Performance
Philosophy
Physics
Political Science
Professional & Technical Writing
Professional Sales
Professional Studies; also at UACCH-Texarkana
Psychology
Public Administration
Public History
Public Service
Reading
Reading/Literacy Coach
Regional Economic Development
Rehabilitation Counseling
Rehabilitation of the Blind
Second Languages
Secondary Education
Service Learning Scholars
Shepherd Program in Poverty Studies
Social Work
Sociology
Special Education
Special Education K-12
Speech Communication
Speech Pathology; also at UAMS
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Superintendency
Systems Engineering
Taxation
Teaching Advanced Placement
Technology Innovation
Theatre Arts
User Experience Design & Web/Mobile Development
Web Design & Development
World Languages
Purpose of Travel
(Required)
Travel during a required semester
Travel during a university break or vacation
Conference or International Research
Leave of Absence for a Required Semester (Authorized Early Withdrawal)
Emergency
Immigration Questions
When does your visa expire?
(Required)
Check the black number in the lower right of your most recent F or J visa.
MM slash DD slash YYYY
If your visa is expired, you must renew it during your travels. Will you renew your visa while outside the US?
(Required)
Yes
No
When is your Program Start Date?
(Required)
Check your I-20 or DS-2019.
MM slash DD slash YYYY
When is your Program End Date?
(Required)
Check your I-20 or DS-2019.
MM slash DD slash YYYY
Do you need a program extension on your I-20 or DS-2019?
(Required)
Your program end date should be the last day of your last semester. You will have an extra grace period after your program end date.
Yes
No
Will you return to UALR for full-time enrollment after your trip?
(Required)
Yes
No, I will transfer.
No, I will graduate.
Other
Travel Plans
Approximate Date of Departure
(Required)
Please submit your best idea of when you will depart the United States. If your plans change slightly, no update is necessary.
MM slash DD slash YYYY
Approximate Date of Return
(Required)
Please submit your best idea of when you will return to the United States. If your plans change slightly, no update is necessary.
MM slash DD slash YYYY
Which countries will you be visiting?
(Required)
Will you miss any class because of your travel?
(Required)
No, I will travel during a university vacation or miss less than 2 days of class.
Yes, I will miss more than 2 days of class.
Yes, I will miss more than 30 days.
Travel During Required Semester
Have you received permission from your instructors to miss class for your travel?
Yes
No
Upload written permission from your instructors.
Written permission may include emails sent from the instructor's UALR email address. Files must be less than 1 MB.
Drop files here or
Select files
Max. file size: 1 MB.
You must bring written permission from your instructions when you submit your I-20 or DS-2019 to the ISS office.
(Required)
I understand
I understand that I must maintain my coursework while outside the US in order to maintain my immigration status and be permitted reentry to the US.
(Required)
I understand
Further describe the reason for your travel during a required semester.
Emergency
We will do what we can to ease your stress during this time.
Approximate Date of Departure
(Required)
Please submit your best idea of when you will depart the United States. If your plans change slightly, no update is necessary.
MM slash DD slash YYYY
Approximate Date of Return
Leave blank if unknown.
MM slash DD slash YYYY
Check your I-20 or DS-2019. Have you received a travel signature within the past 6 months?
Yes
No
I don't know
Have you informed your professors that you will be leave the US for an emergency?
(Required)
Yes
No, I will inform them.
No, please contact them on my behalf.
Do you plan to maintain your enrollment while you are outside the US?
(Required)
Yes, my instructors say they are willing to work with me while I am outside the US.
Yes, but I need to talk to my instructors.
No, I plan to withdraw from class.
I have not yet decided.
If you need to withdraw from your classes, we will need to authorize your immigration record for Authorized Early Withdrawal BEFORE you withdrawal from class.
(Required)
I understand.
Do you have a friend or family member you are giving permission to assist you with your immigration issues while you are outside the US?
Yes
No
Name of trusted friend
First
Last
Email of trusted friend
Enter Email
Confirm Email
Is there anything else we can do for you during this difficult time? If so, please describe.
Authorized Early Withdrawal
If you are withdrawing from classes and leaving the United States, you will need to have authorized early withdrawal to maintain your F-1 status for an easier return.
Have you reviewed the online information about AEW or met with an international student advisor for an Authorized Early Withdrawal consultation?
(Required)
Yes. I reviewed the online information.
Yes. I met with an international student advisor.
No. I will learn more after submitting my request for AEW (Not advised).
Have you purchased your departure tickets?
(Required)
Yes
No
Date of Departure
(Required)
MM slash DD slash YYYY
Upload flight itinerary showing departure from the United States.
(Required)
Accepted file types: pdf, jpg, png, Max. file size: 1 MB.
Approximate Date of Departure
(Required)
MM slash DD slash YYYY
You must bring your flight itinerary and I-20 to the ISS front desk before your AEW request will be processed.
I understand that if I do not submit my flight itinerary and I-20 I will not receive immigration permission to withdraw from class.
When do you plan to return to the US for full-time study?
(Required)
Upcoming fall semester
Upcoming spring semester
Upcoming summer semester
Unknown
Summer classes are often limited. You must check with your program coordinator to make sure you can enroll full-time in the summer.
I understand.
You must contact an international student advisor 30 days prior to your scheduled return.
(Required)
I understand.
You must receive an updated I-20 prior to your return to the US.
(Required)
I understand.
You may only enter the US 30 days prior to the next semester.
(Required)
I understand.
If you are outside the US for more than 5 months, you will need to apply for a new visa prior to your return.
(Required)
I understand.
Acknowledgments for Authorized Early Withdrawal
I verify that all the information within this form is accurate to the best of my knowledge.
(Required)
I verify.
I understand that I must submit a copy of my departure flight ticket within 3 business days from submitting this form.
(Required)
I understand.
I understand that I cannot withdraw from class until after I receive confirmation that I have been approved for Authorized Early Withdraw.
(Required)
I understand.
I understand that I must depart the US on the day scheduled. If I remain in the United States, I will be in violation of my immigration status.
(Required)
I understand.
I understand that I am responsible for all financial and academic aspects of withdrawing from the university. Authorized Early Withdrawal only affects my immigration standing.
(Required)
I understand.
I understand all the content of this form and online at ualr.edu/international/aew. I request an international student advisor to complete the process for authorized early withdrawal.
(Required)
Type your full name in the box below.
Acknowledgments
I verify that all the information within this form is accurate to the best of my knowledge.
(Required)
I verify.
I understand that I must submit my most recent I-20 or DS-2019 to International Student Services on the next business day.
(Required)
I understand.
I understand that I must receive written permission from my instructors to miss class for international travel. I will bring the permission from my instructors when I submit my I-20 or DS-2019.
(Required)
I understand
I understand that my request will be reviewed in the order it was submitted and may take up to 5 business days for processing.
(Required)
I understand.
I understand the office hours for International Student Services and will pick up my I-20 or DS-2019 prior to my departure.
(Required)
I understand.
I understand that if I do not pick up my I-20 or DS-2019 before I leave the US, I will need to make courier arrangements to receive my documents at least one week prior to my return to the US.
(Required)
I understand.
Do you have any further questions or comments?
Captcha
Name
This field is for validation purposes and should be left unchanged.