UIN*
SEVIS ID (If not F or J, put 000.)*
Family Name*
First Name*
Which ONE of the following applies to you?*
Current Visa Status*
Did you hold another visa status in 2012?*
What was the other visa status you held in 2012?
On which date did you change to or enter the U.S. on your current visa status? (MM/DD/YYYY)*
Did you work on campus in 2012?*
Were you a student athlete in 2012?*
Who was your employer in 2012? (Check all that apply.)
*
