Certificate of Financial Responsibility

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Certificate of Financial Responsibility
George Mason University, 4400 University Drive MSN 3A4, Fairfax, VA 22030 - Phone: 703-993-2400
An asterisk (*) denotes mandatory information.
For further information about requesting your I-20 or DS-2019, applying for your visa, and preparing for your studies at Mason, visit the following web site: http://oips.gmu.edu/new-students/

Personal Information

Please print your full name exactly as it appears on your passport or birth certificate. We cannot issue your immigration document (I-20 or DS2019) until we receive this form from you.

Name:

Last

First

Middle

Gender:

Male

Female

Other

Date of Birth:

City & Country of Birth:

City

Country

Country of citizenship:

Country of legal permanent residence:

Email Address:

Telephone:

Fax:

Foreign Residence Address:
Note: This information is required, even if you are currently living in the United States.

US Address:
(if applicable)

Address:

City:

State:

Zip:

To which address would you like your I-20/DS-2019 mailed?

Previous or current Mason identification number:
(if known)

Student Type:

Freshman

Transfer

Graduate

Passport:

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