Download I-20

Information to be Used for I-20 Form:
1. Family Name (surname)_______________________________________________
First (given) name (not middle name)__________________________________
Country of Birth___________________ Date of Birth____________________
Country of Citizenship______________________________________________
Admission Number (if known)_______________________________________
2. Foreign Address_____________________________________________________
_______________________________________________________________
City
State or Providence
Country
Postal Code
3. U.S. address/sponsor address: ______________________________
______________________________
______________________________
U.S. telephone or cell:
________________________
4. This certificate is issued to the student named above for:
____
____
____
____
____
Initial attendance at this school
Change of status request/initial attendance at this school
Continued attendance at this school
School transfer from:_______________________________________
Use by dependents entering the United States
5. Level of education the student is pursuing or will pursue in the United States:
____
____
____
____
____
Associate
Bachelor’s
Masters
Doctorate
Language Training
6. The student named above has been accepted for a full course of study at this
school majoring in __________________The student is expected to report to the
school not later than_____________ and complete studies not later
than_________. The normal length of study is __________________________.
7. English proficiency is required:
____ The student has the required English proficiency.
____ The student is not yet proficient, English Instructions will be given at the
school.