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Program Extension Form

The document is an F-1/J-1 student program extension form. It details the process for international students to apply for a program extension if they will not complete their degree by their current end date. Reasons for extensions include changes of major or research topic, unexpected research problems, or documented medical issues. The form requires signatures from the student and their academic advisor.

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vaibhavrao
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20 views1 page

Program Extension Form

The document is an F-1/J-1 student program extension form. It details the process for international students to apply for a program extension if they will not complete their degree by their current end date. Reasons for extensions include changes of major or research topic, unexpected research problems, or documented medical issues. The form requires signatures from the student and their academic advisor.

Uploaded by

vaibhavrao
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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3141 Chestnut Street

Main Building, Suite 222


Phone: 215.895.2502: Email: ISSS@drexel.edu
Office Hours: Monday – Friday, 9am – 5pm

F-1/J-1 Student Program Extension Form

Family/Last Name: Given/First Name:

Student ID Number: Drexel Email:

Students whose program of study will continue beyond the program end date listed on their I-20/DS-
2019 must apply and receive approval of a program extension before the current program end date.
Students are eligible for an extension if they apply before the program end date, have made
satisfactory progress towards their degree, and have compelling academic and/or medical reasons.
Students who fail to apply for a program extension prior to the program end date on their current I-
20/DS-2019 are considered out of status and no longer eligible for F-1/J-1 visa benefits.

Academic Advisors to complete the following:


The student is expected to complete all requirements for the current program of study, barring any
unforeseen circumstances at the end of the following term. Select the corresponding term the student
is expecting to complete their degree and their final date of term. The end date must directly
correspond with their official academic program calendar. Please note that extension requests cannot
exceed one year.
 Fall
 Winter
 Spring
 Summer
New program end date ____/____/____ (mm/dd/yyyy)

The student’s graduation must be delayed to the above date due to the following compelling reason:
 A delay caused by a change of major
 A delay caused by a change in research topic
 A delay caused by unexpected research problems
 A delay caused by documented medical issues (must submit supplemental proof from a U.S.
medical doctor to be considered for this reason)
 Other** (additional documentation must be submitted with this form explaining the necessity of the program extension)
_____________________________________________________________________

Academic Advisor’s Signature


I am authorized to speak on behalf of the student’s academic progress and verify that the student is making
satisfactory progress towards degree completion.

Student Signature: ________________________________ Today’s Date: ____/____/____ (mm/dd/yy)

Advisor’s Name: __________________________________ Advisor’s E-mail: ____________________________

Advisor’s Signature: _______________________________ Today’s Date: ____/____/____ (mm/dd/yy)

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