*
Required
Personal Data
ASU ID
*
required
Last
*
required
First
*
required
Middle
Email Address
*
required
Cell Number
*
required
Nation of Birth
Nation of Citizenship
Native Language
Visa/Passport Information
Visa Type
*
required
Visa #
*
required
Nation Issuing
Visa Issued City
Date Visa Issued
Passport#
*
required
Nation Issuing
Passport Expiration Date
Travel/I20 Information
I94 #
*
required
Port of Entry
I20/SEVIS ID#
*
required
I20 Issued Date
Date You Signed I20
Local Address
Address 1- Building Name
*
required
Address 2- Room Number
*
required
Address 3
City
State
Zip
Attach I20
*
required
Max file size: 10 MB
Attach I94
*
required
Max file size: 10 MB
Attach Visa
*
required
Max file size: 10 MB
Attach Passport
*
required
Max file size: 10 MB
Attach Class Schedule
*
required
Max file size: 10 MB
Signature and Acknowledgement
*
required
I acknowledge that by placing my initials in the text box provided the information is true and accurate. Also, I understand that changes to my local address and telephone number are permitted but must be reported.
Please provide an email address where we can send a link to your current form.
Email Address :