F AND J REQUEST FOR TRAVEL FORM

I. Instructions
In order to process requests for Travel Endorsements, the International Services Office
will need to have the following documents at least 10 working days prior to departure:
1. Current Document (DS-2019 / I-20)
2. Passport
3. Request for Travel Form
Please note, in order to process travel requests in a reasonable amount of time, these
documents must be submitted no later than 10 working days prior to your departure from
Starkville. If this form is submitted any later, the International Services office cannot
guarantee that your request will be processed prior to your departure.
II. Important Dates
Todays Date _______________________________________
Departure Date _____________________________________
Return Date ________________________________________
Visa Expiration Date _______________________________
Will you apply for a new Visa on your trip? ( ) Yes ( ) No
III. Contact Information
Please write your name as it appears on your passport
______________________________________________________________________
Last Name
First Name
Do you have any other names that may appear on your student records at MSU?
( ) No ( ) Yes. If yes, please list:
______________________________________________________________________
Last Name
First Name
Birthdate ________________________________________
MSU ID Number ___________________________
Local Phone Number _______________________________
E-mail address ___________________________________
IV. ACADEMIC INFORMATION
Has either your major or degree objective changed since you last received
a DS 2019 or I-20 ? ( ) Yes ( ) No
NOTE: If yes, you must make an official change with the Registrars Office.
What is you current major? _______________________________________________

05/07/07

What is your degree level? ( ) BA/BS ( ) MS ( ) Ph.D

Have you already graduated? ( ) Yes ( ) No
Are you graduating this semester? ( ) Yes ( ) No
When do you expect to graduate?
_______________________________________________
Are you currently on Practical Training?
( ) No ( ) Yes. If yes, date it expires ___________________________________
V. F2 / J2 TRAVEL INFORMATION
Each F-2 / J-2 traveler must have an I-20 / DS-2019 endorsed for travel. Please submit
the current document and passport for all individuals planning to travel along with this
form.
(Check One)
( ) Traveling alone
( ) Traveling with spouse and/or children
(List names, country of birth and birth dates)
( ) Spouse and/or children traveling only
(List names, country of birth and birth dates)
NAME

COUNTRY OF BIRTH

BIRTH DATE

Spouse: ______________________________________________________________
Child: ________________________________________________________________
Child: ________________________________________________________________
Child: ________________________________________________________________
VI. SIGNATURE
I certify that I have read all of the information provided on this form and the above
information is true and valid. I also
certify that I have enough funds to support myself in school for at least one year.
__________________________________________________
_______________
Signature
Date

05/07/07