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Student Departure Form

Please use the form below to notify the ISO that you are departing the United States and/or will no longer maintain your F-1 or J-1 program through the University of Rochester. This may include completion of your studies, transfer to another school, leave or absence or early withdrawal, end of post-completion employment, or an approved Change of Status to another immigration category. Some of these actions require additional forms (see below). Please do not use this form to report a temporary trip home or vacation from UR.

This form is for notification purposes and other documentation may be required before the ISO can take action. Please review the following forms and information, as needed:

The Student Departure Form below will notify only the ISO. Please make sure to contact any other University offices that may need to be aware of your departure, such as University Health Service, Residential Life, GLACIER tax software, etc.

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(Please list your name exactly as it appears on the I-20/DS-2019)
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Departure Information
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(If "Scheduled")
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