I-20 REQUEST FORM
Applicant’s Information (PLEASE PRINT CLEARLY):
Family/Last Name _________________________________________
First Name _________________________________________
Middle Name _________________________________________
Date of Birth __________/_______/_____________
Month Day Year
Gender (Male/Female) _______________________________
Country of Birth _______________________________
Country of Citizenship______________________________
I will be applying for F1 (check one): in my home country_________ in the U.S.____________
*If applying in the U.S. (changing status): my current visa is: ______ and my I-94 expires on___________
I will be transferring from: _________________________________ on (date) ______________
Home Country Address (Foreign): ________________________________________________
Street name and number, apt. number if applicable
_______________________________________________________________
City Province/Territory Postal Code Country
U.S. Address (where you will reside while attending NCC):
_________________________________________________________________
Street name and number, apt. number if applicable
_________________________________________________________________
City State Zip Code
Semester I am applying for: Spring _____Summer_____ Fall _____Year________
* If applying abroad: The earliest time I will be available to come to the United States is:
____________/______________/____________
Month Day Year
My major/program of study will be (not ESL):________________________________
I am English proficient: Yes________ No (will need ESL classes) ________