International Student Information Form
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1INTERNATIONAL STUDENT INFORMATION FORM
(This form must be completed once each semester)
PART 1: Please answer all questions.
Name: ______________________________
Date of Birth: ____/____/____
(last / family) (first / given) (middle)
month day year
Person #: ________-________
Visa type: F-1 _____ J-1 _____ Other _____
UB E-mail: ______________________ Non-UB E-mail: __________________________
Country of Citizenship: ___________________ Country of Birth: ___________________
Major: ____________________________ Male _____ Female _____
Bachelor’s _____
Master’s _____
Doctorate _____
Other _____
When will you graduate? Month _______Year ________
Local Address
Street: ______________________________________________ Apt. #________
City: _______________________________ State: ___________Zip Code: ______
Home Telephone #: ____________________ Cell Phone #: _________________
Home Country Address
Address Line 1: ________________________________________________________
Address Line 2: ________________________________________________________
City: __________________________State / Province:__________________________
Country: ____________________________________ Postal Code: ______________
Home Country Phone # (include country code): ________________________________
PART 2: Please complete if applicable.
Spouse and Children Residing in U.S.
Family Name
First Name
Visa
Date of Birth
Country of Birth
Citizenship
Relationship
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