Form 1-17 - Petition For Approval Of School For Attendance By Nonimmigrant Student (Page 10 of 11) in pdf

Form 1-17 - Petition For Approval Of School For Attendance By Nonimmigrant Student Page 10

OMB No. 1115-0070

U.S. Department of Justice

Record of School(s)/Campus(es)

Immigration and Naturalization Service

Instructions

Form I-17 Supplement B must be completed and submitted with Form I-17 if a school system or multi-campus institution is seeking

approval for a number of schools for admittance by nonimmigrant students. Furnish all known information for each school or campus

within the system. If more space is needed to list all schools, attach additional forms as necessary, and number each at the bottom. If an

approved school system seeks to update or correct the information on its original Supplement B, a new Form I-17 must be submitted,

without fee, accompanied by Supplement B, and if applicable, Supplement A. Please PRINT or TYPE all information on this form.

Requested

Initial approval for the following school(s) or

Addition of the following school(s) or campus(es) to the list of approved institutions within the above school

system.

Removal of the following school(s) or campus(es) from the list of approved institutions within the above school

system.

Change or correction in the following information relating to school (s) or campus(es) that have been approved.

Fill in only the information that is to be added to or adjusted in the INS records and the school's three-digit suffix.

2. School or Campus three-digit suffix

School or Campus Name

Mailing Address (include Zip Code)

4. Location (if different from mailing address)

School or Campus Name

2. School or Campus three-digit suffix

Mailing Address (include Zip Code)

4. Location (if different from mailing address)

School or Campus Name

2. School or Campus three-digit suffix

Mailing Address (include Zip Code)

4. Location (if different from mailing address)

School or Campus Name

2. School or Campus three-digit suffix

Mailing Address (include Zip Code)

4. Location (if different from mailing address)

Form I-17 (Rev. 04/05/02) Supplement B

Form 1-17 - Petition For Approval Of School For Attendance By Nonimmigrant Student Page 10