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I-20 Request Form for F-1 Student


 
NOTE: This form is for requests from current continuing students. Please complete all sections on front and back and submit supplemental documents when required. Allow up to 7 business days to process this application. 

Reason for I-20 Form Request: Check One
 
  Add Dependent  
  1. Copy of bank statement(s) or financial support letters 
  2. Copy of dependent’s biographical page from passport 
  3. Copy of marriage certificate or birth certification with English translation 
  4. Complete dependent’s section of this form
 Program Extension 1-20  
  1. Completed Program Extension Form
  2.  Completed Certification of Finances Form
  3.  Gallaudet outstanding balance is cleared
Replacement I-20 
(For Lost, Stolen, Damaged, Travel, I-515A issuance, etc.)   

 		 Program Level Change  
  1. Copy of Gallaudet admission letter
  2.  Completed Certification of Finances Form
  3. Gallaudet outstanding balance is cleared
 Updated I-20
              Financial Information Change
  • Copy of bank statement(s) or financial support letters 
             Name Change
  • Attach Proof of Name Change (Passport example)
 Academic Major Change 
  1. Office of Registrar must reflect your updated major(s)
Personal Information:
 
Last Name: First Name:
Gallaudet ID: Email:
Home Phone: Zoom Phone:
Date of Birth (MM-DD-YYYY) Country of Birth:
Country of Citizenship: Country of Permanent Residence:
SEVIS Number: I-94 Number
Expected Graduation Date (MM/YY) Degree Level:
Term of Return (if applicable): Major:

Local Address: __________________________________________________________________

                         Street Address           

                         __________________________________________________________________

                         City                                                          State                              Zip                            

*This is your permanent address in home country.

Permanent Address: ______________________________________________________________

                                  Street Address            

                                _______________________________________________________________

                                   City                                                          State                              Zip     

I-20 Form Delivery Option:
  •  In-Person Pick Up 
  • FedEx or Express or Standard Mail (It will be sent to local address above, unless different address specified here:                                  
Mailing Address: __________________________________________________________________

                         Street Address            

                         __________________________________________________________________

                         City                                                          State                              Zip                    

Dependent Information (Spouse/Child):
 
First Name Last Name Relationship Birth Date (MM/DD/YYYY) City of Birth Country of Birth Country of Citizenship
             
             
             
Financial Information: 
 NOTE: Student must provide a current bank statement with existing funds in the account. If the bank statement is not in the student's name, the Affidavit of Financial Support section below must be completed. Students sponsored by school, company, agency, foundation or government agency, must attach a letter from that sponsor specifying which costs will be paid. Amounts can be found here (Link to Tuition Fees): ELI or Undergraduate or Graduate


Source of Fund:             
  • Self         
  • Family     
  • Other (school, company, agency, foundation or government agency)  
Affidavit of Financial Support: "I have read the information about the amount needed for tuition costs and living expenses for the period of study at Gallaudet University. I certify that these funds are available, and I accept full responsibility for these expenses. I fully understand that persons coming to the USA on F-1 or J-1 status are expected to study full-time and no student should expect to work to support their education."  

Name of Person Financially Responsible: ________________________________________________ 

Relationship to Student: ______________________________________________________________ 

Signature: _________________________________________________________________________   

Date: _____________________________

I certify the above information is accurate. I am aware that I must provide documentation that I have enough funds to support my educational and living costs

Student Signature: __________________________________________________________ 

Date: _____________________________