Office of University Admissions
323 Dr. Martin Luther King Jr Blvd
Newark, NJ 07102 USA
V719
What type of Visa will you be applying for?
F-1
J-1
Application for I-20/DS-2019
Form and Affidavit of Support
PERSONAL INFORMATION
Name (as displayed on
passport):
Gender: Male
Female
Country of Birth:
Date of Birth:
(MM/DD/YYYY)
Telephone:
Country of Citizenship:
Email address:
DEPENDENT INFORMATION
Complete this section only if your spouse or children will be traveling with you.
Last Name
First Name
Date of Birth
(MM/DD/YYYY)
Relationship to Student
*Please note that $5,000 in financial support is required for a spouse and $3,750 for each additional dependent.
MAILING ADDRESS
Address to which you would like I-20/DS-2019 form sent. Please note NJIT will only mail Form I-20/DS-2019 directly to
student.
Number and Street Address:
City and State:
Post Code: Country:
VISA INFORMATION
Are you current
l
y
in
the United States?
Yes No
If Yes, list your current visa type
:
_________ ___ ___
Are you changing your current immigration status?
Yes
No
If yes, current
:
To:
If yes, how?
If you are currently studying in the United States with an F-1or J-1 visa, please provide:
Visa expiration date (MM/DD/YYYY): SEVIS number:
Name of institution on your I-20 or DS-2019 form:
Last Name
First Name
Middle Name
Middle Name
City of Birth:
Office of University Admissions
323 Dr. Martin Luther King Jr Blvd
Newark, NJ 07102 USA
V719
FINANCIAL INFORMATION
Please read before you submit this form.
1) Financial certification is required for issuance of the I-20 or DS-2019 form.
2) Evidence of financial capability should be official and in English, showing sufficient funds to cover the educational and living
expenses for the duration of study. Costs include, but are not limited to, tuition and fees, room and board, health insurance,
books and personal expenses.
3) Acceptable forms of evidence are: official bank statement, letter from a bank or letter of scholarship. Documents cannot be
more than 6 months old and must be in English.
4) The financial sponsor must complete and sign the bottom portion of this form. If more than one sponsor is needed,
each sponsor must complete a separate form.
2019-2020 ESTIMATED ANNUAL COST OF ATTENDANCE FOR INTERNATIONAL STUDENTS
GRADUATE
UNDERGRADUATE
Tuition and Fees*
$33,744
$33,386
Living Expenses*
$19,400
$20,900
Health Insurance*
$ 1,543
$ 1,543
Total (per year of study) *
$54,687
$55,829
*Figures are subject to change without notice. * A detailed breakdown of costs can be found at: njit.edu/bursar/tuition
AFFIDAVIT OF SUPPORT FROM PERSONAL SPONSOR
This is to certify that I, , have agreed to provide US$ to
Sponsor’s Name
For the purpose of full-time study at New Jersey Institute of Technology.
Student’s Name
I am submitting financial certification indicating the availability of these funds. I further understand that NJIT will
not provide need-based assistance to the applicant, and that I must provide evidence of these funds for one year of the
applicant’s course of study. My relationship to the student is
Sponsor Signature: Date:
(MM/DD/YYYY)
All financial support documents must be official.
ACKNOWLEDGEMENT
With the admittance of this form, I acknowledge that NJIT has the right to deny any financial document deemed unacceptable and can request
additional information at any time. Furthermore, I certify that the information given by me on this form is complete and accurate and I
understand that misrepresentation on this form may be cause for rescinding admission.
Signature of Applicant Date (MM/DD/YYYY)
click to sign
signature
click to edit
click to sign
signature
click to edit
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome