Fillable DOCUMENT REQUEST FORM (Palm Beach State College)

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DOCUMENT REQUEST FORM (Palm Beach State College)

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Rev. 06/29/10
OFFICE OF INTERNATIONAL
ADMISSIONS AND RECRUITMENT
DOCUMENT REQUEST FORM
Student Name:
Student ID Number: Visa Type:________________
I- PLEASE INDICATE THE DOCUMENT (S) NEEDED:
A new I-20 Form (Please complete the Section II. You may need to submit current funding
documents)
A Status Letter - Document certifying your enrollment status at Palm Beach State College.
A Social Security Letter - Document certifying your immigration status and standing at Palm
Beach State College
to confirm your eligibility for a social security number.
Permission to Register at a Second Institution as dually enrolled international student -
Document allowing you to register as dually enrolled student at a second institution on condition
that you also enroll at Palm Beach State College and maintain a full-time course load (as per
immigration regulations) between the two institutions. You must attach the Request to Enroll at
Another College Form signed by a College Advisor along with a College Registrar. Please
remember to request that your official transcript be sent to Palm Beach State College at the end of
the term.
On-Campus Employment Certification Letter- Document certifying your status and eligibility
to engage in part-time on-campus employment at Palm Beach State College.
Full-Time Waiver Form- Document exempting student from taking a full-time course load
(12 credit hours) for a specific term. The laws only allow international student to be part-time
under specific circumstances. Please contact our office for required documents, procedures, and
legal consequences.
Other (please specify): Other: (Please specify)
I authorize the release of information required for the document specified above.
Student’s Signature Date
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Rev. 06/29/10
IF YOU ARE REQUESTING A NEW I-20, YOU MUST COMPLETE THE
FOLLOWING SECTION:
Total # of credits currently enrolled for:
U.S. Visa Expiration Date: / / Passport Expiration Date: / /
II- WHY ARE YOU REQUESTING A NEW I-20?
My F-1 visa has expired and I plan to travel abroad to apply for a visa renewal
I have changed my major
I am going to my home country to apply for the F-1 visa
I need to apply for a Program Extension (Please submit a letter from your academic
advisor or the chair of your academic department to verify the estimated date of graduation
from Palm Beach State College)
I am currently out-of-status and will travel outside of the U.S. to be readmitted in legal F-1
status.
I am currently out-of-status and will apply for reinstatement with local INS office.
I am applying for a change of status to F-1.
I need a replacement I-20 for my lost or mutilated I-20.
I need a new 1-20 to submit with Form I-515 to local INS office.
I am currently on OPT post-completion of degree and need an I-20 to travel outside of U.S.
(MUST attach copy of your EAD).
New I-20 is for use by my spouse and/or children for travel abroad and reentry to the U.S.
NOTE: 1) You must present a bank letter showing availability of U.S. funds that will be
enough to support yourself and your dependents. 2) For each dependent, you MUST
provide Last Name, First Name, Date of Birth, Place of Birth and Relationship to you.
Other: (Please specify)
IMPORTANT: IF TRAVELING OUTSIDE THE U.S., when is your expected return/reentry date?
Month/_____Day/____Year/____
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Completed 1 February 2021

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