Scholar Completion Notification Form

Scholar Completion Notification Form

The following information should be completed and submitted to the ISS Office (International Students and Scholars) prior to your departure. Notification of intent to end participation is required BEFORE the ending date on the Form DS-2019.

Section I: To be completed by the J-1 scholar
Name Name First Last
CWID
Email
Expected Date of Departure Expected Date of Departure / MM / DD YYYY
Please check all that apply:

Please check all that apply: I have successfully completed my program objectives. I have NOT met my program objectives. (Please comment below) I will be leaving within 30 days after the expiration of my DS-2019. I will be leaving prior to the end date on my DS-2019.
Comments:
List any cultural activities you have attended/participated in during your program at OSU.
I certify that:
1. I have paid my bursar in full and will be responsible for any charges that appear after my departure.
2. On Campus Housing - I have cancelled my housing contract. Off Campus Housing – I have informed my landlord of
my intent to vacate.
3. All J-2 dependents not previously departed will be departing the US with me.

I certify that:
1. I have paid my bursar in full and will be responsible for any charges that appear after my departure.
2. On Campus Housing - I have cancelled my housing contract. Off Campus Housing – I have informed my landlord of
my intent to vacate.
3. All J-2 dependents not previously departed will be departing the US with me. Agree
Signature

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
link

Scholar Completion Notification Form

Scholar Completion Notification Form The following information should be completed and submitted to the ISS Office (International Students and Scholars) prior to your departure. Notification of intent to end participation is required BEFORE the ending date on the Form DS-2019.

Scholar Completion Notification Form

The following information should be completed and submitted to the ISS Office (International Students and Scholars) prior to your departure. Notification of intent to end participation is required BEFORE the ending date on the Form DS-2019.