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Office of International Student Services

International Travel

Travel Signature Request

Name*
First Last
UALR ID Number*
Email*
Enter Email Confirm Email
Local Physical Address*
Street Address Address Line 2 City State ZIP Code
Phone Number*
Classification*
- Doctorate
- Masters
- Undergraduate
- IELP
- If currently on OPT, use OPT Update form.
Major Area of Study*
Purpose of Travel*
- 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?*
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?*
- Yes
- No
When is your Program Start Date?*
Check your I-20 or DS-2019.
When is your Program End Date?*
Check your I-20 or DS-2019.
Do you need a program extension on your I-20 or DS-2019?*
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?*
- Yes
- No, I will transfer.
- No, I will graduate.
Travel Plans
Approximate Date of Departure*
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*
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?*
Will you miss any class because of your travel?*
- 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
You must bring written permission from your instructions when you submit your I-20 or DS-2019 to the ISS office.*
- 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.*
- 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*
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
- No
- I don't know
Have you informed your professors that you will be leave the US for an emergency?*
- 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?*
- 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.*
- 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?*
- 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?*
- Yes
- No
Date of Departure*
Upload flight itinerary showing departure from the United States.*
Accepted file types: pdf, jpg, png.
Approximate Date of Departure*
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?*
- 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.*
- I understand.
You must receive an updated I-20 prior to your return to the US.*
- I understand.
You may only enter the US 30 days prior to the next semester.*
- 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.*
- I understand.
Acknowledgments for Authorized Early Withdrawal
I verify that all the information within this form is accurate to the best of my knowledge.*
- I verify.
I understand that I must submit a copy of my departure flight ticket within 3 business days from submitting this form.*
- I understand.
I understand that I cannot withdraw from class until after I receive confirmation that I have been approved for Authorized Early Withdraw.*
- 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.*
- 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.*
- 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.*
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.*
- 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.*
- 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.*
- 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.*
- 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.*
- 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.*
- I understand.
Do you have any further questions or comments?

Contact
- Office of International Student Services
- University of Arkansas at Little Rock Education 101 2801 S. University Avenue
  
  Little Rock, AR 72204
- Phone:
  501-683-7566
  Fax:
  501-683-7567 (fax)
  Email: internationalservices@ualr.edu

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