Office of International Scholar and Student Services
SEVIS Enrollment Status Report Form
 

F-1 & J-1 Students/Scholars at NC State:

All F-1 and J-1 students or scholars at NC State - as well as their dependent family members in F-2 or J-2 status - must have their programs and presence enrolled in the new federal reporting system known as SEVIS. If you have not yet enrolled in SEVIS, please submit this form as soon as possible, but no later than May 10, 2003 AND take the necessary actions described on the OISSS SEVIS webpage. If you are already enrolled in SEVIS (your I-20 will have been issued after October 15, 2002 or your DS-2019 will have been issued after Feb 10, 2003 and either will have a bar code on the right hand side), you should also complete this online form but be sure to indicate if any further processing is necessary.


  Who is required to enroll in SEVIS?

You are required to enroll in SEVIS before August 1, 2003 if you:

After reviewing the information, OISSS will work with you to ensure your record will be entered into SEVIS. Our goal is to get everyone's record in before mid July, and your patience, understanding, and punctuality in submitting the required information is very much appreciated. Please go to the OISSS SEVIS webpage for detailed information on how to enroll in SEVIS. Basically, you will need to complete and submit this form, have your advisor complete the Advisor's Report , and bring your updated financial information to an apppointment with an OISSS advisor. Note: International alumni who have graduated and are doing F-1 OPT or J-1 Academic Training MUST also enroll in SEVIS, while international students in a visa type other than F-1 or J-1 do NOT need to enroll in SEVIS at this time.


  Please see the Office of International Scholar and Student Services main website for general information about our office.


Contact and Personal Information
Please provide your biographical information below.
Last/Family Name:
First Name:
Middle Name:
Birth Date (MM-DD-YYYY):
Gender: Male Female
Email:
Daytime Phone:
Preferred time to meet an OISSS advisor:
Note: We will try to accommodate special requests and emergencies in priority order, but cannot guarantee all requests.
Profile (Visa) Subtype:
Circumstances:
Department/major (full name):
Academic Level:
When will you complete your program?
Note: This is just an estimate - the date we use will rely primarily on the date your Advisor provides.
Marital Status:
Note: If your spouse and/or children are in F-2 or J-2 status, please complete the Dependents Section below.

 
Immigration Information
Country that issued your Passport:
Passport Number:
Passport Expiration Date (MM-DD-YYYY):
Visa (Control) Number:
Visa IssuancePost (City/Country):
Visa Expiration Date:
Admission (I-94) Number:
Contact Information
Permanent Residence in your Home Country (No P.O. Boxes)
Street Address:
City:
Province/Territory/State:
Country:
Postal Code:
Residential Address in the U.S. (where you live now - not a P.O. Box)
Street Address:
City:
State:
Zipcode:
Financial Information (see OISSS SEVIS webpage for more information)
Finances:
Site of your Primary Activity (where you study or work now)
Department Name and Building/Room#:
Street Address:
City:
State:
Zipcode:
Emergency Contact Information (For OISSS use only - Not for SEVIS)
Emergency Contact in U.S. (name & relationship):
U.S. Emergency Contact Phone (+area code):
Emergency Contact in Home Country (name & relationship):
Foreign Emergency Contact Phone (+country/city codes):
Dependent Information
Complete this section only if your spouse and/or children (under 21 years old) are in the U.S. and are in F-2 or J-2 status.

Spouse

Last/Family Name of Spouse:
First Name of Spouse:
Spouse's City of Birth:
Spouse's Country of Birth:
Spouse's Country of Permanent Residence:
Spouse's Country of Citizenship:
Birth Date (MM-DD-YYYY) of Spouse:
Gender of Spouse: Male Female

Child #1

Last/Family Name of Child #1:
First Name of Child #1:
Child #1 City of Birth:
Child #1 Country of Birth:
Child#1 Country of Permanent Residence:
Child #1 Country of Citizenship:
Birth Date (MM-DD-YYYY) of Child #1:
Gender of Child#1: Male Female

Child #2

Last/Family Name of Child #2:
First Name of Child #2
Child #2 City of Birth:
Child #2 Country of Birth:
Child#2 Country of Permanent Residence:
Child #2 Country of Citizenship:
Birth Date (MM-DD-YYYY) of Child #2:
Gender of Child#2: Male Female

Child #3
Last/Family Name of Child #3:
First Name of Child #3:
Child #3 City of Birth:
Child #3 Country of Birth:
Child#3 Country of Permanent Residence:
Child #3 Country of Citizenship:
Birth Date (MM-DD-YYYY) of Child #3:
Gender of Child #3: Male Female

Additional Information

Please describe any other information we should know (e.g., your stay will expire in May, you will transfer to another school, you will travel this summer, you will change your major or level, you anticipate immigration difficulties, etc.) that you would like to include in this report. Remember: you must still take action to enroll in SEVIS - submitting this form does not enroll you, and you must enroll in order to maintain your lawful status. After we receive your report, we will contact you with further information and an appointment time.

Thank you for completing this information, which we will use in recording your program in SEVIS. By submitting this information you are certifying that the infomation is correct and are requesting, unless otherwise not appropriate or possible, a new Form I-20 or DS-2019 for yourself and any dependent family members, so that you can maintain your lawful status in the U.S. An OISSS advisor will contact you about when to come in to complete the SEVIS enrollment- please be sure to bring to your appointment any additional financial documentation or other materials listed on the OISSS SEVIS webpage or upon request by an OISSS advisor.

Submit Your Report

 

Updated on April 29, 2003 by OISSS