Request to Withdraw Form - International Student Services

Name *

First Last

Student ID number *

What is your city of birth? *

Please check that your computer does not auto-fill this field with "Boise"

Boise State Email Address *

I studied outside the US for the Fall 2020 semester *

I will not be attending on-campus classes starting from *

Please indicate when you will stop attending classes on campus.

Date I plan to leave the US (or date you left the US, if you've already left)

I would like to return to Boise State in the future *

Semester and Year I would like to return

I am planning to take online courses during this time away from campus *

Do you have a signature in the travel endorsement section of your I-20 (page 2)? *

What date is the travel signature? *

I am transferring to another US university *

When do you plan to start at the new US university? *

Comments or questions for International Student Services

For example, please let us know if you would like to meet with an ISS advisor about this process.

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