International Admissions I-20 Request Form

I-20 Request Form

Office of International Admissions
Palm Beach State Student ID
Name

First NameMiddle NameLast NameSuffix
Email Address
for example username@my.pbsc.edu
- Name as it appears on passport
  
  First NameMiddle NameLast NameSuffix
- Date of Birth
  
  MonthDayYear
- Gender
- Country of Birth
- Country of Citizenship
- Purpose
  
  Other
- What visa/status do you presently hold?
  
  Other
- What visa are you applying for?
  
  Other
- Will you be applying for the student visa in your country?
- Will you be applying to change your visa status in the U.S.?
- Current or Intended Educational Program at PBSC
- Major
- School Transferring From
  Required if transferring from another educational institution in the United States
- Passport Number
- Expiration Date of Passport
  
  MonthDayYear
- I-94 Number
- Upload a copy of the Visa and bio pages of your passport
  
  PDF documents only
  Cancelof
- Upload copy of your I-94 (front and back)
  
  PDF documents only
  Cancelof
- Upload a copy of all previous I-20's
  
  PDF documents only
  Cancelof
- Foreign Address (Address in home country)
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Address in the U.S. (if available) / No P.O. Box
  
  Street Address
  
  Street Address Line 2
  
  CityState
  
  Zip Code
- Employment Type
- Prospective Employer Name
- Prospective Employer Address
  
  Street Address
  
  Street Address Line 2
  
  CityState
  
  Zip Code
- Duration of Employment
- From:
- To:
- Submit a bank letter showing a minimum balance of $24,000 USD for admissions for fall or spring terms and $28,875 USD for the summer semester
- Upload Bank Letter
  
  Cancelof
- I wish to add a dependent
- Relationship
- Name
  
  First NameMiddle NameLast NameSuffix
- Date of Birth
  
  MonthDayYear
- Gender
- Country of Birth
- Country of Citizenship
- Foreign Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Please provide proof of relationship, and copy of passport bio and visa pages for dependent.
  
  Cancelof
- I wish to add a second dependent
- Relationship
- Name
  
  First NameMiddle NameLast NameSuffix
- Date of Birth
  
  MonthDayYear
- Gender
- Country of Birth
- Country of Citizenship
- Foreign Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Please provide proof of relationship, and copy of passport bio and visa pages for dependent.
  
  Cancelof
- I wish to add a third dependent
- Relationship
- Name
  
  First NameMiddle NameLast NameSuffix
- Date of Birth
  
  MonthDayYear
- Gender
- Country of Birth
- Country of Citizenship
- Foreign Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Please provide proof of relationship, and copy of passport bio and visa pages for dependent.
  
  Cancelof
- I wish to add a forth dependent
- Relationship
- Name
  
  First NameMiddle NameLast NameSuffix
- Date of Birth
  
  MonthDayYear
- Gender
- Country of Birth
- Country of Citizenship
- Foreign Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Please provide proof of relationship, and copy of passport bio and visa pages for dependent.
  
  Cancelof
- By Typing my full name below, I declare the information above is accurate and true to the best of my knowledge. I understand that any omission or falsification may result in my rejection or dismissal from the College.
- Date
  
  MonthDayYear
Should be Empty: