International F-1 Additional Information Form

International Student (F-1) Additional Information

Personal Information

First Name

Last Name

Email Address

Date of Birth

StarID (log-in created when applying for admission online)

Tech ID (student number assigned after applying online)

Address Information

Permanent Address in Home Country

Country

Street

City

Region

Postal Code

Address in the USA where you will be living while attending NHCC (if known)

Country

Street

City

Region

Postal Code

Immigration Status

Current Immigration Status

What institution are you currently attending?

Do you currently live in the United States?

Dependent Information

Do you have dependents (spouse and children under 21) who are seeking entry to the the US on a F-2 visa?

How many dependents?

Dependent #1

Dependent #1 Name

Dependent #1 Date of Birth

Dependent #1 Relationship to You

Dependent #2

Dependent #2 Name

Dependent #2 Date of Birth

Dependent #2 Relationship to You

Dependent #3

Dependent #3 Name

Dependent #3 Date of Birth

Dependent #3 Relationship to You

Dependent #4

Dependent #4 Name

Dependent #4 Date of Birth

Dependent #4 Relationship to You

Dependent #5

Dependent #5 Name

Dependent #5 Date of Birth

Dependent #5 Relationship to You

Emergency Contact

Emergency Contact Name

Emergency Contact Phone

Emergency Contact Email

Electronic Signature

By signing this form (typing name as signature), I certify that all the information reported on this form is complete and accurate and that I agree to all electronic signature terms and conditions set forth by Minnesota State College and Universities.

Please type your name in the box below to sign this form.