Application For The Certificate Of Eligibility Form I20 Or Ds2019

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Application for the Certificate of Eligibility (Form I-20) or (DS-2019)

For Degree Students

International students who are admitted into a degree program at CSI/CUNY will need to obtain a Certificate of Eligibility (Form I-20) or (DS-2019), in

order to enter and/or remain in the U.S. as an F-1 or J-1 student. This requirement applies whether you are a new student, a transfer student from another

U.S. university, or a student transferring between CUNY colleges.

(Please print clearly)

Sex (check one) ⃞ Male ⃞Female

Name_________________________________________________________

(Family name as in passport) (Given name as in passport) (Second given, or middle name, if any, as in passport)

2. Present Mailing Address _________________________________________________________________________________

________________________________________________________________________________________________________

(Number and street) (City, State) (Country) (postal code)

3. Telephone Number__________________________________

E-Mail _________________________________________

4. Date of Birth_____________________________________

City of Birth _____________________________________

(Month/Day/Year)

5. Country(ies) of Citizenship_______________________________ Country of Residence ______________________________

6. Permanent Overseas Address ______________________________________________________________________________

________________________________________________________________________________________________________

(Required by U.S. Government Regulations) (Number and street) (City, State) (Country) (postal code)

7. Address in U.S.A. (if known) _____________________________________________________________________________

________________________________________________________________________________________________________

(Number and street) (City) (State) (Zip code)

8. Expected Semester of Enrollment:

Fall 20 ________ Spring 20 ___________

9. Degree Program & Academic Major ________________________________________________________________________

10. Are you currently studying at a U.S. institution or college? _____________________________________________________

11. Do you currently hold F-1/J-1 status? ______________________________________________________________________

TO BE COMPLETED BY APPLICANTS ALREADY IN THE U.S.

If you are currently in the U.S., please indicate your immigration status. Attach a copy of the passport pages with the passport number, expiration date of

passport, and the U.S. visa stamp. Include copies of both sides of Form I-94 for yourself and accompanying family members.

12. Immigration Status__________

I-94 Admission#_______________ I-94 Expires On___________________

Month/day/year

(Attach copies of ALL your previously issued Forms I-20 or DS-2019)

13. University that issued most recent Form I-20 SEVIS # N ____________________________________________

14. Current U.S. school: Name: ___________________________________________________________________

Address: _____________________________________________________________________________________

(Number and street) (City) (State) (Zip code)

The Center, 06/14