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I-20/DS-2019 Request Form
Personal information
Please print your full name exactly as it appears on your passport or birth certificate. We cannot issue your
immigration document (I-20 or DS-2019) until we receive this form from you. Please complete the form and attach all required
documents. Return the form with your admissions application.
Applicant’s name*__________________________________________________________________________________________
Last (family name) First Middle
Date of birth* ________________________________
Month/day/year
City of birth ________________________________________ ________________________________________
Country of birth* ____________________________________ _______________________________________
Country of citizenship*_______________________________ ________________________________________
Country of legal permanent residence*_________________ _________________________________________
Email__________________________ _______Telephone____________________ Fax____________________
Foreign residence address* (NOTE: This is required information, even if you are currently living in the US)
U.S. address (if applicable)_____________________________________________________________________
Current occupation (i.e., graduate student, researcher, etc.)___________________________________________
To which address would you like your I-20/DS-2019 mailed? Please circle one (U.S. or foreign address)
Previous or current VCU identification number (if known)____________________________________________
Student Type: __Freshman __ Transfer __Graduate
VCU Office of Admissions
408 West Franklin Street, Box 843012 Richmond, Virginia 23284-3012
Phone: (804) 828-6016; Fax: (804) 828-1829
______________________________________________________________________________________________________________________
Immigration Information
What type of immigration document are you requesting from VCU? __ I-20 (F-1 status) __DS-2019 (J-1 status)
Please attach a copy of your passport identification page or if your passport is unavailable, a copy of your birth certificate.
Are you currently in the United States? __ Yes* __ No
*Please attach a copy of your current immigration document (Form I-20, DS-2019 or other) and I-94 car
d.
I
f yes:
1
.
What is your current immigration status? __ F-1 __ J
-1
O
ther:___________________________________________
2
.
If currently in F-1 or J-1 status, please list school or university you are attending
.
3. Are you planning to leave the United States before coming to VCU? __ Yes __No
4.
If yes, when?___________________________
__
Dependents
If your family will accompany you, you must show evidence of an additional U.S. $5,000 per year for your spouse and U.S. $5,000 for each child. For
each dependent, please attach a copy of passport identification page or birth certificate.
Please complete: __I plan to come alone.
__ I plan to bring the following dependents who will enter the United States with me. (Complete below.)
__The following dependents are currently with me in the United States and will remain with me.
Name_______________________________________________________________________________________
Last (family name) First Middle
Date of birth_________________________________________________________________________________
Country of citizenship_________________________________________ ________________________________
City and country of birth___________________ ____________________________________________________
Country of legal permanent residence__________________________
(Please continue on separate sheet if needed.) _ Spouse _Child
• You must demonstrate that you have sufficient funds available for your academic and living expenses.
You
or your sponsor will be responsible for all payments according to scheduled VCU payment dates for each semester
.
Funding
All students requesting a DS-2019 or I-20 from VCU must provide proof of sufficient funding for academic and living expenses as well as health insurance. You or your
designated sponsor will be responsible for all scheduled payments to VCU. Note that official and original financial documentation is required prior to issuing the I-20
or DS-2019. Documents that show students are potential candidates for scholarships are not acceptable. If your sponsor is paying your tuition, fees, room and/or
board, your sponsor’s billing authorization for payment must be unconditionally guaranteed and a copy of the billing authorization, which should include your student
V number, must be provided by the student to the Student Accounting Department each semester. Payment is due by the due date indicated on the bill from the
Student Accounting Department. The student is ultimately responsible for payment, should the sponsor default on their payment.
VCU Office of Admissions
408 West Franklin Street, Box 843012 Richmond, Virginia 23284-3012
Phone: (804) 828-6016; Fax: (804) 828-1829
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VCU is required to review all financial documentation prior to issuance of an I-20 or DS-2019. Sufficient funding must be shown for the first year of study. The
estimate of expenses on the VCU I-20 and DS-2019 is an approximation, and it is the student’s responsibility to examine all expenses by viewing these pages from the
VCU Office of Student Accounting:
http://accounting.vcu.edu/tuition/calculator/
Estimated costs are as follows for the 2019-2020 academic year (note that actual costs may vary by program and student lifestyle and do not include summer
tuition and fees). The VCU Board of Visitors meets each May and reserves the right to change any and all tuition and fees. Funding source amounts listed are per
year in US Dollar.
Graduate (Doctoral)
Tuition
$22,212
Fees
3,728
Total
25,340
Living
Expenses
10,823
Books/Insurance
2,000
Total
12,823
Undergraduate Degree
Graduate (Master's)
Tuition
$32,742
Tuition
$25,956
Fees
3,162
Fees
3,128
Total
35,904
Total
29,084
Living
Expenses
10,823
Living Expenses
10,823
Books/Insurance
2,000
Books/Insurance
2,000
Total
12,823
Total
12,823
Total
$48,727
Total
$41,907
Total
$38,163
*Based 15 undergraduate credits
Official financial documents are required. This includes:
• An official scholarship letter from a valid sponsoring agency indicating a scholarship has been granted on the student’s behalf to study at VCU.
• Official bank statements (checking, savings, certificates or deposit, or money market accounts only). Real estate or property, corporate assets, insurance, or salary
letters are not acceptable. All official documents should be dated within 3 months.
Type
Amount
Personal funding
__________________
Funding from parent or individual sponsor
Funding assistance from VCU
Government sponsor
Private organization/employer
Other (please specify)
Total __________________
Further information on payment information is posted at http://accounting.vcu.edu/tuition/payments/
Applicant: I certify that the information provided is correct and complete. I will be responsible for adhering to all university tuition, fees, room and board,
and health insurance payment schedules, including providing the Office of Student Accounting with Financial Guarantees in schedule with university policy. I
also understand that I must keep a current active U. S. mailing address on file with the Office of Records and Registration and check my VCU official e-mail on
a frequent basis. All bills are available on VCU eService’s and should be reviewed and paid in accordance with university policy.
Signature of applicant Date Last Name (printed) First Name MI
Parent/sponsor: I certify that I have read the information provided by the applicant on this form, and it is true, accurate and complete to the best of my
knowledge, and that the funding is available as noted.
Signature of parent Date
Last Name (printed) First Name MI
Relationship to applicant Address
REVISED 5/14/2018
VCU Office of Admissions
408 West Franklin Street, Box 843012 Richmond, Virginia 23284-3012
Phone: (804) 828-6016; Fax: (804) 828-1829