Full-Time International Student Data Sheet
Please complete this form very carefully as information provided is used on the I-20
Print and complete your name exactly as it appears on your passport.
LAST (FAMILY) NAME ____________________________________________________________________
GIVEN NAMES ___________________________________________________________________________
HOME COUNTRY MAILING ADDRESS
STREET AND NUMBER ________________________________________________________________________________________
CITY ___________________________________________ PROVINCE/TERRITORY ____________________________________
COUNTRY ______________________________________ POSTAL CODE ____________________________________________
COUNTRY OF BIRTH _______________________________________________________________________________________________
COUNTRY OF CITIZENSHIP _________________________________________________________________________________________
CITY OF BIRTH ____________________________________________________________________________________________________
DATE OF BIRTH: MONTH ______________ DAY ________ YEAR ___________
MY NATIVE LANGUAGE IS __________________________________________________________________________________________
IMMIGRATION STATUS: (Visa) _____________________________________________________________________________________
SEMESTER START DATE (check only one)
FALL SEMESTER (August to December) SPRING SEMESTER (January to May) SUMMER SEMESTER (May to August)
YEAR ____________
YOUR INTENDED PROGRAM OF STUDY/MAJOR _____________________________________________________________________
EMAIL ADDRESS ___________________________________________________________________________________________________
CELL/MOBILE _____________________________________________________________________________________________________
WILL ANY DEPENDENTS BE LIVING WITH YOU IN THE UNITED STATES? YES NO
PLEASE SUBMIT A SEPARATE DEPENDENT DATA SHEET/PASSPORT COPY /VISA COPY and FINANCIAL CERTIFICATION
FOR EACH OF YOUR DEPENDENTS.
PAYMENT METHOD (Please select one)
Self
Scholarship. If yes, please provide name _______________________________________________________________________
Other
r. 6/2020
How would you like to receive your I-20?
SENT BY U.S. POSTAL SERVICE: No expense to student. Please provide full mailing address below.
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
SENT BY COMMERCIAL CARRIER (FEDEX/DHL): Please ask for instructions.
Please note: STUDENTS ARE RESPONSIBLE FOR COST OF COMMERCIAL SHIPPING.
PICK-UP FROM OFFICE (SELF ONLY)
TRANSFER STUDENTS ONLY
CURRENT UNITED STATES ADDRESS
*STREET AND NUMBER (*APARTMENT NUMBER-IF APPLICABLE)
_____________________________________________________________________________________________________________
*CITY _____________________________________________ *STATE _________________ * ZIP CODE____________________
Are you planning to travel outside the U.S. before you start classes at Owens? YES NO
If yes, please provide intended departure date: (MM/DD/YYYY) __________________________________________
ATTESTATION:
I ________________________________________________________________ CERTIFY THAT ALL OF THE INFORMATION
PROVIDED ABOVE IS TRUE AND ACCURATE.
SIGNATURE ________________________________________________________________ DATE__________________________
Please indicate how you heard about Owens Community College:
FRIENDS/ADVISORS FROM MY HOME COUNTRY TOLD ME ABOUT OWENS
FRIENDS/ADVISORS FROM ANOTHER PART OF THE U.S. TOLD ME ABOUT OWENS
FRIENDS/ADVISORS FROM THE TOLEDO AREA TOLD ME ABOUT OWENS
ONLINE
OTHER, PLEASE DESCRIBE _________________________________________________________________________________
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