I-20 Data Form (F-1 Status Visa)
Required fields are marked with an asterisk (*). These are mandatory.
School Name: Date:
Person Competing Data: Phone #:
1. *Family name:
2. *First name:
3. Middle Name :
4. Suffix:
5. *Date of Birth:
6. *Gender:
7. *Country of Birth:
8. *Country of Citizenship:
9. *Issue Reason:
Initial attendance * Grade:
Initial attendance –Beginning School Date / /
Continued attendance
1. Current Session
End Date / /
Next Session / /
Start Date / /
Projected Date of Graduation / /
School transfer
Transfer from what school in USA
Reinstatement requested
Other, please state reason for other:
Required fields are marked with an asterisk (*). These are mandatory.
10. Admission number:
(From form I-94-Issued to a student who has been admitted into the U.S.)
11. Driver’s license number:
12. Driver’s license issue state:
13. Social Security Number:
14. Individual Taxpayer ID Number:
15. *Foreign address
a. Address 1:
b. Address 2:
c. City:
d. Province/Territory:
e. Postal code:
f. Country:
16. *U.S. Address
a. Address 1:
b. Address 2:
c. City:
d. State:
e. Zip Code (8 digit, if possible):
17. * Education Level
a. Primary
b. Secondary
18. * Program start date / /
19. * Program end date
a. o End of school year Date / /
b. o Graduation Date / /
20. Ending Trimesters dates: / / / / / /
(elementary)
Ending Quarter dates: / / / / / / / /
(secondary)
21. English Proficiency
a. Yes
b. No
i. ENOS Program
ii. Other Explain:
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Required fields marked with an asterisk (*) are mandatory.
22. * This school estimates the student’s average costs for academic term of 9 months to be:
a. *Tuition and fees: $
b. *Living Expenses $ (Must be estimated, if not know)
c. *Total: $
22. *This school has information showing the following as the student’s means of support, estimated for an academic term of 9 months.
a. *Student’s Personal Funds (usually .00) $
b. *Funds from another source (specify type & source)
family
host family
parish
financial aid
scholarship $
c. *Total $
The total of #21 and #22 must equal.
Please complete and email or fax mail to:
Mr. Christopher Cosentino
410 547-5393 fax: 410-547-5566
Department of Catholic Schools
320 Cathedral Street
Baltimore, MD 21201
For more information: Phone: 410 547-5515
This form is available in WORD from this office and can be downloaded
and completed on your computer or the form must be typed.
(No handwritten I-20s will be accepted.)
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