Vacation Request Form

VACATION REQUEST FORM

IMPORTANT REMINDER FOR STUDENTS

International students are eligible to take two months of vacation per year. Please be aware that missing a session in your current level will interrupt your academic progress and no vacation will be approved until you complete a level. Vacation requests must be submitted two weeks in advance. All vacation plans must be discussed and approved by your International Student Advisor, Dr. Elke Kleisch (ekleisch@nati.edu). Once approved, you must be registered for upcoming classes. To qualify for vacation, you must meet the requirements below and submit all documents with this form. I-20 will be signed upon proof of enrollment.

VACATION REQUIREMENTS

• Attend classes full-time for 20 consecutive weeks • Plan to return and continue a full-time course of study • Show proof of registration for upcoming classes • Show proof of insurance (you must be covered by insurance while on vacation) • Must complete current level

▌ STUDENT INFORMATION

First Name

Last Name

Country of Birth

Birthday Date

Current Language Level

Completed Language Level

Phone Number

Session Return Date

Last Day Of Current Class

Program End Date

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Gender

Female

Male

Prefer not to answer

I am requesting the vacation time stated above and I authorize the DSO to change my program dates in my SEVIS record to the above indicated start and end dates. I am aware that if I change my mind, I must notify the DSO BEFORE my program end date. Failure to do so will mean I will be required to continue attendance.

STUDENT'S SIGNATURE(Required)

Type your formal name

Today's Date

Name

This field is for validation purposes and should be left unchanged.