Fillable I-20 REQUEST FORM If you need an F1 (Cornell University)

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I-20 REQUEST FORM If you need an F1 (Cornell University)

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The I-20 REQUEST FORM If you need an F1 (Cornell University) form is 2 pages long and contains:

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  • 41 other fields

Country of origin: US
File type: PDF

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___________________________________________________________________________________
I-20 REQUEST FORM
If you need an F1 student visa (see “International Students” on the web), please complete this form and return it with a copy
of the biographical data page of your passport and a cashier’s check, a money order drawn on an American bank, or a bank
statement guaranteeing sufcient funds to cover the cost of your study. You will then be mailed an I-20 form which you should
take to the United States consulate or embassy in your country to get your F1 student visa. We cannot accept facsimile cop-
ies of this form or of supporting documents. Please let us know if you have any questions, or if we can help you in any way.
Country of birth:______________________________ Country of citizenship: ___________________________________
City of birth: __________________________________________ Date of birth: _________________________________
month/day/year
TOEFL Score: __________________________ or IELTS Score: ________________________
Sources of nancial support (in U.S. dollars):
Personal or family funds (attach the Financial Verication Form
guaranteeing sufcient funds.) U.S. $ ____________________
Scholarship or grant (attach a signed copy of the letter or award.) U.S. $ ____________________
Total in U.S. dollars must equal the program fee of $1,410 per credit, plus $450
per week estimated living expenses, plus funds to cover either the Cornell U.S. $ ____________________
student health fee or heath plan (between approximately $175 and $1,800).
Your signature: ____________________________________________________________________________________
Name (please print): ________________________________________________________________________________
exactly as it appears on your passport
Mailing address: ___________________________________________________________________________________
number and street city
state/province zip/postal code country
Home phone:___________________ Cell phone: ___________________ E-mail address: _______________________
with area code/country code
with area code/country code
May we send occasional text messages to your cell phone? ❏ Yes ❏ No If yes, you will be responsible for any charges
that result from these messages.
Are you currently attending college in the U.S.?
❏ Yes ❏ No If yes, where?_________________________________
Are you coming to Cornell for another program? ❏ Yes ❏ No
If yes, when? ❏ Fall ❏ Spring ❏ Summer What is the program?________________________________________
Mail materials to Cornell University School of Continuing Education and Summer Sessions, B20 Day Hall, Ithaca, NY 14853-
2801 at least six weeks prior to the beginning of class.
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FINANCIAL VERIFICATION FORM
Part I: Family’s Verication of Financial Support
I, the undersigned: (full name of parent or guardian)
(address of parent or guardian)
parent or guardian of: (name of student)
hereby certify:
that I am fully responsible for the expenses of the student named above, and that I am able to send him/her
U.S. $ weekly for his/her tuition, books, living expenses, etc. for study at Cornell University for the coming
semester(s). I have a bank account at
name of bank
with sufcient funds to cover these expenses
for weeks.
Parent’s signature: Date:
Part II: Bank Statement
This is to certify that Mr./Ms. , whose signature appears above, has ample funds at our
bank to meet all the expenses of his/her child/ward during the coming semester at Cornell University. This certication does
not constitute a statement of liability on my part or the bank I represent.
Signature: Date:
Title: stamp or seal of bank:
Bank:
Address:
Return materials to Cornell University School of Continuing Education and Summer Sessions, B20 Day Hall, Ithaca, NY
14853-2801 at least six weeks prior to the beginning of class.
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I-20 REQUEST FORM If you need an F1 (Cornell University)

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Completed 7 March 2021

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