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 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)

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.

If your visa is expired, you must renew it during your travels. Will you renew your visa while outside the US?(Required)

Yes

When is your Program Start Date?(Required)

Check your I-20 or DS-2019.

When is your Program End Date?(Required)

Check your I-20 or DS-2019.

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

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.

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.

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

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

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.

Approximate Date of Return

Leave blank if unknown.

Check your I-20 or DS-2019. Have you received a travel signature within the past 6 months?

Yes

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

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

Date of Departure(Required)

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)

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?

Comments

This field is for validation purposes and should be left unchanged.

International Travel

Immigration Questions

Travel Plans

Travel During Required Semester

Emergency

Authorized Early Withdrawal

Acknowledgments for Authorized Early Withdrawal

Acknowledgments

Contact

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