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Get Request For Leave Of Absence - Indiana State University

Rary or Permanent Part I. To be completed by Student Family Name: First Name: Middle Name: Major: Country of Citizenship: Date of Birth: / / MM DD YYYY Email: SEVIS #: ISU ID#: Phone #: Part II. Departure Information The purpose of this form is to allow IPS to adjust or end (terminate) your SEVIS record because you are leaving Indiana State University and the U.S. temporarily or permanently. If you are leaving ISU and the U.S. temporarily (excluding summer vacation), or you.

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