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Wichita State University | International Education | 1845 Fairmount Street | Wichita KS 67260-0122
tele: (316) 978-3232 | fax: (316) 978-3777 | e-mail: iss@wichita.edu
03/2020
I-20 Request Form
Name: __________________________________________________________________________
Surname(s) Given Name(s)
WSU ID: __________________________ SEVIS ID: _______________________________
Address: _________________________________________________________________________
WSU Email: ____________________________________________@shockers.wichita.edu
Phone: _______________ Degree Program: □ Undergrad □ Graduate □ Intensive English
I am requesting this I-20 for:
□ Replacement (explain): _____________________________________________________________
□ Other (explain): ___________________________________________________________________
□ Create Dependent I-20: (so your spouse or child can apply for an F-2 visa)
You must also submit:
a new Certification of Financial Support covering the student and all dependents
Dependent Information ** Write name exactly as it appears on the dependent’s passport or provide a copy of
dependent’s passport.
Surname(s): ________________________________________________________________________
Given Name(s): _____________________________________________________________________
Date of Birth: ________________ (mm/dd/yyyy) Country of Birth: _________________________
City of Birth: _____________________ Country of Citizenship: _________________________
Relationship to student: □ Husband □ Wife □ Son □ Daughter
Please allow 3 business days for your new I-20 to be issued. An email will be sent to your
@shockers.wichita.edu account when it is ready.
Student’s Signature: ________________________________________Date: ___________________