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LIU Post
720 Northern Blvd.,
Brookville, N.Y. 11548-1300
Email: post-intl@liu.edu
www.liu.edu/post/international
LIU Brooklyn
1 University Plaza
Brooklyn, N.Y. 11201-8423
email: Admissions@brooklyn.liu.edu
www.liu.edu/Brooklyn/international
UNDERGRADUATE I-20 REQUEST: 2018/2019 Academic Year
Note: This form must be completed in its entirety
Reason for I-20 Request:
□ Initial I-20 (first time in U.S School)
□ Change Education Level
□ Travel & Re-Entry
□ Addition of Dependent
□ Change of Status by travel outside the U.S.A
□ Change of Status by application in the U.S.A.
□ Transfer from a U.S.A School
□ Reinstatement
□ I-20 Extension
I am an accepted/enrolled student and attend/will attend:
□ LIU Brooklyn
□ LIU Post
Please check below if you do not require an I-20:
□ I do not require an I-20 because I am a U.S. Citizen or U.S. Permanent
resident
□
□
□
□
□
□
I-20 Checklist:
A copy of your passport
Completed and signed Undergraduate I-20 Request form
Completed and signed Financial CertificateUndergraduate Study form
Proof of funds:
o Bank Letter or Statement dated within last 6
months
o Organizational Sponsorship
o Personal Funds
o Scholarships
Transfer-In form (if applicable)
Dependent form (if applicable)
All international applicants who need an I-20 to obtain an F-1 Visa must complete the section below:
1. Please print your name exactly the way it appears on your passport
Last Name (Surname)______________________________ First Name (Given):__________________________ Middle:_____________________
LIU ID #:________________________________________
Gender: Male
Female
Country of Birth:__________________________________________
Date of Birth (mo/day/year)__________________________________
Country of Citizenship:_____________________________________
Country of Permanent Residence:____________________________
Primary Language:________________________________________
2.
Permanent Foreign Address
Number and Street:____________________________________________________________________________________________________
City:______________________________________________________
Postal Code:______________________________________
Country:___________________________________________________
3.
Address in the United States (required if your transfer your I-20 from another institution in the U.S.):
Number and Street:____________________________________________________________________________________________________
City:______________________________________________________
Postal Code:______________________________________
Country:___________________________________________________
I prefer to have my I-20 mailed to:
□ Permanent Foreign
□ U.S. Address
□ Pick-Up (LIU Post Only)
4.
Are you currently in the U.S.A?
□ Yes
□ No
a. If yes, what is your current visa type?: □ F-1
□ Another Type (list):___________________
i. If you have an F-1 visa, please complete the Transfer-In form, and provide your:
1. SEVIS ID #:___________________________________________________
2. Is your I-20 in active status?: □ Yes
□ No (please explain):_______________________________________
3. Do you plan to travel outside the U.S. before school starts: □ Yes
□ No
5.
Dependents: Will a spouse or child accompany you to LIU?
□Yes
□No
A student who wishes to have his/her family member(s) accompany him/her must complete the Dependents Form and document financial
support for each family member per calendar year of study on the Financial Certification Form.
I understand that falsification of any information on this application is grounds for immediate dismissal.
Signature of Applicant: ________________________________________________________________
Print Name: _________________________________________________________________________
Date:___________________________
I 20 Application Undergraduate.pdf (PDF, 181.33 KB)
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