WESTCHESTER CAMPUS • 434 Main Street, New Rochelle, NY 10801
Office of International Admissions 914-740-6406
Office of International Student Services 914-740-6791
International Student Check-In Form
You must complete the entire form
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Name:!!_________________________________________!!!!_______________________________________________!!!_____________________________!!
Last Name First Name Middle Name
Monroe College Student ID#:!_____________________________________________________________!Visa Type:!______________________!
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!If you don’t know your ID #, ask your advisor
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Start Term (circle one): January/Winter 20___ April/Spring20___ September/Fall 20___
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PERMANENT HOME INFORMATION (in your home country/where your parents live):
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Address:!______________________________________________________________!!!__________________________________________________________!
Street/PO Box! ! ! ! ! ! City/Town/Parish!
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Home Country:!_________________________!Postal Code:!_____________!Phone (with country code): _______________________________!
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LOCAL INFORMATION (where you’re living while you are in the U.S.):!!!!!!
c I live on campus!
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Street & Apartment:!____________________________________________________________________________________________________________!
City:!____________________________________________________________________!State:!____________________________!Zip:!_________________!!
Cell Phone:!!_______________________________________________!Home Phone:!______________________________________________________!
Personal Email Address:!_______________________________________________________________________________________________________
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Any change to my local contact information must be reported to SEVIS Coordinator within 10 days.!
IN CASE OF EMERGENCY, I GIVE MONROE COLLEGE PERMISSION TO CONTACT THE FOLLOWING PERSON:
!
Name:!____________________________________________________________________________________________________________________________!
Street & Apartment:!____________________________________________________________________________________________________________!
City: ____________________________________________________________________!State:!____________________________!Zip:!_________________!!
Cell Phone:!!_______________________________________________!Other Phone:!_______________________________________________________!
Relation:!_________________________________________________________________________________________________________________________!
If you have any allergies or medical information we should know about, please call us and provide documentation.
As an international student in F-1 status, I understand that I must register for at least 12 credits (9 credits for graduate
students) each required semester and I must attend all of my classes. I understand that if I do not attend my classes, or if I
work without proper authorization, I am violating my F-1 status. I know that I must obtain a travel signature on my Form I-20 if
I wish to travel outside of the U.S. I also understand that if I have any academic or immigration questions, that I should meet
with my International Student Counselor in the Student Services Office (undergrad students) at Main Hall, New Rochelle, phone
914-740-6420, or in KGS (graduate students), 145 Huguenot St, 914-740-6699.
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X___________________________________________________________________________!!!!___________________________________________________!
!!Student Signature! ! ! ! ! ! ! ! ! Date (month, date, year)
