I-20 Request Form printable pdf download

I-20 Request Form

If you will need a Form I-20 from Life University, please fill out this form and return to the Office of

International Student Services. A Form I-20 cannot be issued to you until your financial statement has been

approved. English proficiency established (if required) and acceptance into Life University has been granted.

Miss

Mrs.

Mr.

Last Name ____________________________ First Name ____________________ Middle Name __________________

Date of Birth __________________________ Country of Birth ______________________________________________

Mailing Address ___________________________________________________________________________________

City _________________________________ State _________________________ Zip __________________________

Will a spouse and/or child be included on your I-20 as dependents?

Yes

If yes, please provide the following information for each:

Relationship to you (i.e. wife, husband, son, daughter) ____________________________________________________

Name ____________________________________________________________________________________________

Date of Birth __________________________ Country of Birth ______________________________________________

Relationship to you (i.e. wife, husband, son, daughter) ____________________________________________________

Name ____________________________________________________________________________________________

Date of Birth __________________________ Country of Birth ______________________________________________

Are you transferring from a United States high school or university?

Yes

Your program of study:

Pre-Professional Program (Chiropractic, Undergraduate Program)

Doctor of Chiropractic

Masters

Undergraduate Your major ______________________________________________________________________

Signature __________________________________________________________ Date _________________________

Life University, Office of Enrollment, 1269 Barclay Circle, Marietta, GA 30060

REV 09/2011

I-20 Request Form