Oiss Application For I-20 Page 2
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1
2OISS APPLICATION FOR I-20
PERSONAL DATA
Visa Type:
WSU Email:
SEVIS ID (From I-20):
WSU ID:
Please Check:
Male
Date of Birth (Month/Day/Year):
Mr.
Mrs.
Gender:
Female
Dr.
Ms.
Country of Citizenship:
Country of Birth:
Last Name:
First Name:
Middle Name:
Current Degree Program:
BA
BS
MA
MS
Ph.D.
Pharm. D.
Other (Please Specify):
__________________________________
Major:
Academic Department:
Program Start Date:
Program End Date:
*
FINANCIAL RESOURCES (If Required, Marked by Asterisks
on Page 1)
Student Personal Funds:
Funds From This School:
(Scholarships, Assistantships, etc.)
Funds From Other Sources:
On Campus Employment:
(Specify Source)
FOREIGN ADDRESS
Street:
City:
Province:
Postal Code/
Country:
Zip Code:
U.S. ADDRESS
Street:
City:
State:
Zip Code:
TELEPHONE
Home:
Work:
Mobile:
Student’s signature
I will pick up I-20
: ____________________________________________
Date: _______________________
OISS STAFF ONLY
Application Reviewed By
: _______________________________________
Date: _______________________
42 W. Warren, Suite 416 ◊ Detroit, MI 48202 ◊ (313) 577-3422 ◊ FAX (313) 577-2962
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