LOS ANGELES SOUTHWEST COLLEGE

Office of International Student Services

EARLY DEPARTURE FORM FOR F-1 STUDENTS
Students in F-1 immigration status who have finished an academic program at LASC or are leaving a program early, including OPT, should submit this completed form to LASC ISS prior to departing the US.
GRADUATING STUDENTS: F-1 students have 60 days and to depart the US, change immigration status, be admitted to a new degree program at LASC or another university, or begin OPT or Academic Training. You cannot reenter the US from abroad during the grace period.
AUTHORIZED EARLY WITHDRAWAL:F-1 students who are leaving their programs early have 15 days in which to depart the US. This includes F-1 students on post-completion Optional Practical Training (OPT) who are permanently departing the US prior to the end date of their OPT employment authorization document (EAD).
Today’s Date: / LASC ID:
First Name: / Last Name:
Forwarding address: / Apt #
City:
/ State/Province: / Postal Code:
Email address: / Phone number:--
FUTURE PLANS:
I graduated in semester of 20and am departing the US and not returning in the immediate future.
Date of departure from US
*LASC ISS will verify your departure date in the SEVIS system.
I have NOT completed my program at LASC yet, but am departing the US and not returning in the immediate future.
Date of departure from US . LASC ISS will verify your departure in SEVIS.
I am an exchange student and will complete my program at LASC on .
I will be working under Optional Practical Training (F-1).
I am transferring to another school in the US.
Where?:
I am applying for a change of US immigration status tostatus.
Other (Reason)
Updated 11/22/10 / Los Angeles Southwest College
1600 Imperial Highway Los Angeles, CA 90047
Phone: (323) 241-5277 Fax: (323) 242-5577