Your Personal Information (* must be filled )
　 　
　 Status School Transfer  Change Status Initial Attendance Reinstatement
　 　
　 VisaF1     M1
　 　
　 Gender Male     Female
　 　
　

First Name: *                                                                             Last Name: *

　     
　 Date of Birth *                                                                                 
　
　  Foreign Address:*
　  
　 City: *　                     Country:*                                                         Postal Code:
　      
　  USA Address:
　
　 City:                                                          State                                                         Postal Code:
　     
　 Country of Birth:*                                   City of Birth:*                                           Country of Citizenship:*
　                                    
　 Start Date:*                                            Length of Study (Month):*                      Fund Amount*
　                                    
　 　
　 Fund Source Student's Personal   Relative    Friend
　  
　 Phone Number: *                                  Mobile / Alternate Phone Number:      Contact
　                                   
　 Valid Email Address: *   (lowercase letters only)                               
　                  
　 Confirm Email Address: *
　  
　 　
　 Description
　
　 　
　

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　 This site was last updated 10/08/08