International Student Office
800 US Hwy 29 N, Building H/700
Athens, GA 30601-1500
Fax: 706-583-2531
Transfer Clearance Form
Return to: International Student Office/ Athens Technical College/ 800 US Hwy 29 N/ Athens, GA 30601/ fax: 706-369-5756
To Be Completed By Student
Student’s Name: ____________________________________ Athens Technical College Student ID #: ________________________
Student’s Current Address: _____________________________________________________________________________________
Student’s Telephone Number: __________________________________________________________________________________
I give permission for my present school to release the information requested on this form:
Signature _______________________________________________ Date _______________________________________________
To Be Completed By International Student Advisor at Present School

Is student currently attending the school last listed in SEVIS?
Yes
No
Student is currently enrolled in a full time program and has been enrolled since ______________________________________
Student did not complete last course of study. His/her last day of attendance was ____________________________________
Student is in reinstatement or change of status proceedings.
Other __________________________________________________________________________________________________
Has the student had any financial problems with your institution?
Yes
No
To the best of your knowledge, is the student “in status” with USCIS?
Yes
No
(If no, please explain on the reverse side.)
SEVIS ID # _______________________________________________________________________________________________
To Be Completed By International Student Advisor at Present School
Transfer Clearance Date
Signature of School DSO _____________________________ Print Name and Title _____________________________
Email of DSO ______________________________________
Date __________________________________________
School Name __________________________________________ Phone Number _______________ Fax Number ______________
School Address _______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Athens Technical College does not discriminate on the basis of race, color, creed, national or ethnic origin, gender, religion, disability, age, political affiliation or
belief, veteran status, or citizenship status (except in those special circumstances permitted or mandated by law). The following individuals have been designated to
coordinate the college's implementation of nondiscrimination policies: Celeste Taylor, Section 504 and the Americans with Disabilities Act (ADA) Coordinator,
Building H, Office H-748, 706-355-5081 and Dr. Leslie Crickenberger, Title VI, Title VII, and Title IX Coordinator, Building J, Office J-211, 706-355-5140.