Student Visa Checklist Template (Page 4 of 4) in pdf

15. Valid until = DD/MONTH/YYYY (It may appear as “Expiration Date” in your passport)

a. Your passport MUST be valid until at least November 2017.

16. Issued by = Place where your passport was issued (located in lower right of US

passport). Usually distributed by United States Department of State or regional passport

authority.

17. Applicant’s Home Address and email address = Your permanent address and email

a. Telephone Number(s) = Home AND cell phone number

18. Residence in a country other than the country of current nationality = If you are a US

citizen, but your permanent address is in another country, OR if you are a non-US citizen

and your permanent address is in a country different from your national passport (ex:

non-US citizen living in the US with a Greencard).

19. Current Occupation = Student (even if you work while in school)

20. Main purpose of the journey = Studies

21. Intended date of arrival in Spain = 9 JANUARY 2017

22. Number of Entries requested = Multiple Entries

23. Applicant’s Address in Spain = Calle Miguel Angel 8, 28010 Madrid, Spain

24. Leave all boxes blank

25. Leave all boxes blank

26. Data of the educational establishment or research centre in case of applying for a

student or Research visa

a. Name of educational establishment = Instituto Internacional

b. Address of the educational establishment = Calle Miguel Angel 8, 28010 Madrid

Spain

c. Telephone of the educational establishment = 34.91.319.9942

d. Email address of the educational establishment =

drkuehl@syr.edu

e. Intended start date of studies = 9 JANUARY 2017

f. Intended date of end of studies = 12 MAY 2017

g. LEAVE ALL OTHER BOXES BLANK

27. Place and Date = Where (the city) and when (the date) you completed this form. The

location MUST correspond to the Consulate’s jurisdiction. Since you are applying

through the Spanish Consulate in Washington, DC, the place must be within

Washington, D.C., MD, NC, VA or WV!

28. Signature (DO NOT FORGET!)

Student Visa Checklist Template Page 4