I-20 Request Form

I-20 REQUEST FORMApplicant’s Information (PLEASE PRINT CLEARLY):Family/Last NameFirst NameMiddle Name___________________________________________________________________________________________________________________________Date of Birth __________/_______/_____________Month Day YearGender (Male/Female)______________________________Country of Birth _______________________________Country of Citizenship______________________________I will be applying for F1 (check one): in my home country_________ in the U.S.____________*If applying in the U.S. (changing status): my current visa is: __________ and expires on______________Foreign Address: _______________________________________________________________Street name and number, apt. number if applicable_______________________________________________________________City Province/Territory Postal Code CountryU.S. Address (where you will reside while attending NCC):_________________________________________________________________Street name and number, apt. number if applicable_________________________________________________________________City State Zip CodeI am English proficient: Yes________ No (will need ESL classes) ________Semester I am applying for: Spring _____Summer_____ Fall _____Year________* If applying abroad: I wish and will be able to come to the United States to begin my studies on:____________/______________/____________Month Day YearMy major (program of study) will be: ______________________________________________

My educational expenses will be covered as follows:My personal funds in the amount of: $______________________________ (see attached bank letter)Room and board will be provided by: _________________________________________ (see attached letter of residence)NameSponsor: ____________________________________ (see attached form I-134 and appropriate financial documents)NameWhen my I-20 form is ready:_____ Call/Email me at (phone number/email address): ________________________________________ Call the following person: ____________________________at _____________________________ Mail it to this address (only if applying abroad): _______________________________________________________________________________________________________________I have checked and confirm that all of the information I have provided on this form is correct:_______________________________________________Applicant’s Signature__________________Today’s DateThe best phone number to reach me is: (_________) ____________________________My email address is: _______________________________________________________Checklist:___This I-20 Request Form (completed in its entirety)___Letter of Residence (notarized)___Affidavit of Support (notarized with financial documents attached)___Personal bank statement (if applicable)___I-539 Change of Status Form (required only if you are changing your status in the U.S.) and a copy of current visa, I-94form, DS-2019 (if applicable) and any other extension documents___A check or money order (NO CASH) for $300 payable to USCIS (required only if you are changing your status in theU.S.)