F-1 I-20 Request Form

for Prospective Students

Please type or print clearly and complete all applicable fields. You must attach to this form all required immigration documents (financial documents,
copy of passport, etc.) and submit them with your application to [email protected]. For reason of privacy, security and fraud
prevention, the Form I-20 must be issued directly by a school to the nonimmigrant student, his or her dependents, or, for minors, to their parent or
guardian.

PURPOSE:

Initial I-20 (from Abroad) Transfer from U.S. School Change of Status (Current Status _______ )

APPLICANT INFORMATION: Please type or print name as it appears on passport.

Surname(s)/Last/Family Name(s):

First Name(s)/Given Name(s):

E-mail Address:

Date of Birth (DD/MM/YYYY): Gender: Male Female

Country of Birth: City of Birth: Country of Citizenship:

Start Semester: Fall Spring Summer

Intended Program: ID EAP AAP PSE Graduate Direct Advanced MAP MAP Standard Graduate PSE

Intended Major (e.g., Biology, Chemistry, etc.):

FOREIGN ADDRESS: Please complete with student or parent’s home country address.

Street Address:

City: Province/Territory: Postal Code:

Country:

MAILING ADDRESS FOR I-20: Please list the address you would like your I-20 mailed to. Please note that the address provided must belong to the student
or parent, per SEVP Guidance.

Street Address:

City: Province/Territory: Postal Code:

Country: Phone Number (Required):

University of the Pacific • [email protected] Last Updated: January 16, 2020

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Surname(s)/Last Name(s): First Name(s)/Given Name(s):

UNIVERSITY OF THE PACIFIC – I-20 REQUEST FORM FOR PROSPECTIVE STUDENTS

LOCAL U.S. ADDRESS: Mandatory for I-20 transfer students or individuals currently residing in the United States.

Street Address:

City: State: Zip Code:

Phone Number: County:

DEPENDENTS:
Do you have dependents you would like to add to your I-20? Yes No

If yes, please list all dependents who will be accompanying you to live in the United States during your studies. Only your legal spouse and dependent
unmarried children under the age of 21 can be claimed as dependents. If your spouse and/or child(ren) are accompanying you to the United States, you
must show an additional $7,200 for your spouse/child and $3,600 for each additional dependent. A copy of each passport and proof of relationship (marriage
license or birth certificate) must also be submitted to University of the Pacific for issuance of the dependent I-20.

Please list names as they appear in passports.

Dependent 1 Dependent 2

Relationship Spouse Child Spouse Child

Surname(s)/Last Name(s)

First Name(s)/Given Name(s)

Middle Name(s)

Date of Birth (DD/MM/YYYY)

Gender

Country of Birth

Country of Citizenship

Dependent 3 Dependent 4

Relationship Spouse Child Spouse Child

Surname(s)/Last Name(s)

First Name(s)/Given Name(s)

Middle Name(s)

Date of Birth (DD/MM/YYYY)

Gender

Country of Birth

Country of Citizenship

Applicant Signature: Date:

Signature must be handwritten, digital signatures will not be accepted.

University of the Pacific • [email protected]

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