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International Student & Scholar Services Forms

Important forms and requests for international students and scholars who are attending or will be attending MSUM.

Process for submitting forms for International Student and Scholar Services:

Complete the form in full – all areas of the form need to be filled out. See below for signature options.
Submitting by email:
Email completed form
1. Save form, attach to email, and send through your official mnstate.edu account (we will accept this email as your signature)
  OR
2. Print form, sign it manually, and scan it. This can be sent through your official mnstate.edu email
  - If the form requires signatures from other parties (advisor, department chair, etc.), please email to the next person in the approval chain.
  - If documentation is required with the form, please send as an attachment.
Submitting by mail: Send completed form with signature, including any required documentation via U.S. mail.

Form	Description
Form AR-11 Change of Address	Description International students need to keep their address current with USCIS and need to inform ISSS of an address change through the Information Change Reporting Form.
Form Concurrent Enrollment Form	Description International students who are simultaneously taking full-time enrollment with a combination of courses from MSUM and another SEVIS approved college or university.
Form Diplomat Application	Description Application to become a diplomat for new international students.
Form Immunization Forms	Description Minnesota law (Chapter 135A, Section 135A.14) requires that all students born after 1956 must be immunized against Tetanus (Td or Tdap) completed within the last 10 years and a dose of a MMR (measles, mumps, rubella). Please provide these two vaccination dates on the immunization form.
Form I-539 Application to Change Nonimmigrant Status Form	Description Reinstatement is an option for an F-1 student who fails to maintain status and wishes to regain status without leaving the U.S. Read the application instructions for reinstatement.
Form Information Change Reporting Form	Description International students must report address changes, opt, employment and unemployment periods.
Form In-state Scholarship Appeal Form	Description If international students have an extenuating circumstance that may prevent you from adhering from establishing the scholarship requirements you can use this form to appeal the scholarship denial.
Form Leave of Absence	Description International students who want to take a semester off during the academic year (Fall or Spring Semester) and not enroll in courses must receive authorization for a leave of absence.
Form Program Extension Form	Description Students must request a program extension a minimum of 2-3 weeks prior to the I-20 expiration date.
Form Request a Letter Form	Description This form is to request an official letter from MSUM on your behalf for various reasons like graduation, enrollment, invitations, annual expenses, etc.
Sample Invitation Letter	Description To support the application for a B-2 visa. The following suggestions are meant as ADVICE only. We cannot guarantee how U.S. consulates will approach each individual situation.
Form UnitedHealthcare Insurance Refund Application	Description This form can be used to apply for a health insurance refund. Conditions apply.
Form Volunteer Service Hours Form	Description International students can receive in-state tuition scholarships by doing volunteer service hours.

Admissions & Readmissions Forms

Form	Description
Form Financial Information Form	Description This form is to submit financial certification indicating you have documented support for the estimate of annual expenses.
Form Readmission Acknowledgement for Out of Status Form	Description If you are out of status (immigration) and have not been at another institution while in the U.S. you will need to fill in the form.
Form Readmission Application	Description This application must be submitted in order to start the process of being readmitted to MSUM.
Form Readmission Sponsor and International Student Agreement Form	Description The form is an agreement for sponsors and international students so the student can be readmitted to MSUM.
Form Starter Pack Program Form	Description A program offered to international students to lighten their travel load.

Employment Related Forms

Form	Description
Form Curricular Practical Training (CPT) Form for F-1 Students and Advisors	Description These forms must be completed for an international student to get work authorization for employment that is required by your degree or is credit bearing. More information on CPT requirements.
Form STEM OPT Reporting Form	Description International students must report address changes, opt, employment and unemployment periods.
Form I-983 STEM OPT Form	Description International students from certain Science, Technology, Engineering and Mathematics (STEM) programs can use this form to apply for a one-time 24 month extension. More information on STEM OPT.
Form I-765 Application for Employment Authorization	Description If an international student cannot find employment opportunities on campus they must request employment authorization based on severe economic hardship. Read the authorization process for severe economic hardship employment.