Forms: Visa Request Form for Dependents
Visa Request Form for Dependents
Print this form, fill it out and deliver it to the OISS office at the address below. It will take 7 days to process.
| Today's Date: | |
| Family/Last Name: | |
| First/Given Name: | |
| Date of Birth: | |
| Local Address: | |
| Foreign Address: | |
| E-mail Address: | |
| Daytime telephone: | |
| Status (check one): | ___Masters ___Ph.D. ___Undergraduate ___ELI |
| Department: | |
| Anticipated date of graduation: | |
| Funding ** (Personal, family funds, T.A., etc.): |
** If you are a graduate student on contract with the U of D (teaching assistant, research assistant, etc.), you must provide a letter from your Department stating the amount of funding you will receive for the coming academic year. As this amount appears on the I-20 form, the I-20 will not be prepared until the Office for International Students & Scholars (OISS) has received the information. If you are not funded, a personal bank statement is required. You need to show $3000 per dependent.
| Arrival Date of Dependents: |
Dependent/s Information:
Dependent 1| Last Name: | |
| First Name: | |
| Date of Birth (mm/dd/yyyy): | |
| City & Country of Birth: | |
| Citizenship: | |
| Relationship: |
Dependent 2
| Last Name: | |
| First Name: | |
| Date of Birth (mm/dd/yyyy): | |
| City & Country of Birth: | |
| Citizenship: | |
| Relationship: |
Dependent 3
| Last Name: | |
| First Name: | |
| Date of Birth (mm/dd/yyyy): | |
| City & Country of Birth: | |
| Citizenship: | |
| Relationship: |
I certify that I have medical insurance coverage, and that I will obtain medical insurance for my dependent(s) while they are in the U.S. Spouse insurance MUST be purchased within 30 days of arrival of dependent to be covered for pregnancy, etc.
| Signature: | |
| Date: |
