Fillable First Time Freshman International Student Type: Select one (Virginia State University)

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First Time Freshman International Student Type: Select one (Virginia State University)

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First Name: Last Name
International Student Type: Select one
First Time Freshman
Transfer Graduate
Primary Country of Citizenship Secondary Country of Citizenship:
Primary Email Address Alternate Email Address
Primary Telephone Alternate Telephone
MAILING ADDRESS:
Mailing Address Line 1: Mailing Address Street
Mailing Address Line 2 Mailing Address Apartment #, Suite #, Loft #, etc.
Mailing Address Line 3 Mailing Address City, State , Zip
Mailing Address Line 4 Mailing Address Country
PERMANENT ADDRESS:
Permanent Address Line 1 Permanent Address Street
Permanent Address Line 2 Permanent Address Apartment #, Suite #, Loft #, etc.
Permanent Address Line 3 Permanent Address City, State , Zip
Permanent Address Line 4 Permanent Address Country
International Applicant Supplement - Part 1
Virginia State University
AGENT ADDRESS:
Agent / Agency Name
Agent Address Line 1 Agent Street Address
Agent Address Line 2 Agent Apartment #, Suite #, Loft #, etc.
Agent Address Line 3 Agent City, State , Zip
Agent Address Line 4 Agent Country
Agent Email Address Agent Telephone
Applicant Signature Applicant Signature Date
Failure to provide this information may delay or prevent the processing of your Form I - 20.
Virginia State University, VA 23806
(804) 524-5055 (Fax)
gradadmiss@vsu.edu
admiss@vsu.edu
Transfer Admissions
Graduate Admissions
P. O. Box 9018
P. O. Box 9054
Virginia State University, VA 23806
(804) 524-6981 (Fax)
transferadmissions@vsu.ed u
Please return this International Applicant Supplement form to Virginia State University as follows:
First Time Freshman Admissions
P. O. Box 9018
Virginia State University, VA 23806
(804) 524-5055 (Fax)
Virginia State University
International Applicant Supplement - Part 2
AGENT
If you are using a third party individual or organization, paid or unpaid, to assist you with your
application process at Virginia State University, please provide the information requested below.
I am not using anyone to assist me with my application.
To assist me with my application, I am using the person and/or agency identified below.
I give consent to the University to release information concerning my application and the
admissions process verbally, in writing, or in the form of copies of written records to the
agent/agency listed below. In the absence of a written statement from me to the contrary, such
consent will expire upon completion of the admissions process.
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First Time Freshman International Student Type: Select one (Virginia State University)

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Completed 15 August 2021

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