I-20/DS-2019 Request for New Graduate Students - UCI ...

UCI International Center 

2014-2015 I-20/DS-2019 Request for New Graduate Students 

Submitting this form will allow UC Irvine to issue an I-20/DS-2019 for you to apply for an F-1 or J-1 student visa. Mail this ORIGINAL 

form to your admitting academic department. Please read instructions before completing this form. 

Section One: Personal Information 

Last Name, First Name, Middle Name (if applicable): Print this information exactly as it appears in your passport. 

Date of Birth: Remember to write the date in MONTH/DAY/YEAR (MM/DD/YYYY) format. 

Permanent Address: Must be an actual address, P.O. Boxes are not an acceptable address. 

A copy of your passport biographical information page must be included. 

Your UCI Email address MUST be included to process a visa document, please visit this website: 

https://ucinetid2.nacs.uci.edu/activate/menu.html and follow directions to activate your UCI NET ID. 

Section Two: Visa Information 

What type of visa will you be applying for? 

o F-1 Visa: 

• Most common visa for international students in the United States. 

• Majority of UCI international students are on an F-1 visa. 

• Student’s requesting F-1 will receive an I-20 Visa Document. 

o J-1 Visa: 

• Used by Education Abroad Program (EAP) students 

• Students sponsored by government or other agency that requires a J-1 visa 

• Student’s requesting J-1 will receive DS-2019 Visa Document. 

Are you currently in the U.S. on another visa status (H-1B, TN, etc.)? 

o If you plan to change your current status to F-1 or J-1 you need to indicate how you plan to get an F-1 or J-1 

student status. There are two different ways to obtain F-1 or J-1 status: 

• 1) Travel outside the U.S. (preferably your home country), apply for F-1 or J-1 visa. Re-enter the U.S. in F-1 

or J-1 status; or 

• 2) File a Change of Status application (Form I-539) with the U.S. Citizenship and Immigration Service 

(USCIS). 

You must be in valid immigration status to file this application. 

USCIS processing time is 90-120 days. 

If you are in B-1/B-2, or F-2 visa status you cannot enroll until you receive F-1/J-1 status. 

You may not file this type of application if you are currently on WT/WB, M-1, C, D, K, or are 

subject to the Two-Year Home Residency Requirement. 

o If you are currently in the U.S., and attending school at UCI and will be changing to a new degree, check this box 

and move onto the next section. 

Section Three: Dependent Information (if applicable) 

Who is a dependent of an F-1/J-1 visa holder? 

o Spouses and Children (unmarried and under the age of 21) may apply for F-2/J-2 visas. 

If you request a document from UCI for a dependent, attach a photocopy of the passport biographical page [Required to 

issue a visa document for your dependent]. 

You must verify available funding of $4,500 for each dependent. 

Section Four: Mailing Information 

To ensure that yourI-20/DS-2019 Visa Document arrives securely and promptly UCI only offers express mailing for your Visa 

Document. 

o eShipGlobal: This is an online service that allows you to easily arrange and pay for express mailing with your credit 

card. Visit: https://study.eshipglobal.com to arrange and pay for this service. You will need your UCI student ID 

number, mailing address, e-mail address, phone number, and credit card information. 

UCI International Center • Irvine, CA 92697-5255 • P: 949.824.7249 • F: 949.824.3090 • internationalcenter@uci.edu • www.ic.uci.edu 

IC Office Use Only: Date Received:__________ Advisor’s Initials __________ Ready By: _________ Revised on: 03.06.2014



Section Five: Funding Information 

UCI must verify that you have sufficient financial support to meet your educational and living expenses for at least one 

academic year. Students beginning their programs during summer must show proof of living expenses for summer and 

summer fees [if applicable]. Living expenses per month: $1,417. 

We are required to review documents written in English and U.S. Dollars. If your bank does not provide this, you must 

submit a notarized official translation. The U.S. Consulate will require an original document. 

If your bank statement is NOT in U.S. Dollars, you may provide an online conversion to U.S. Dollars in addition to the 

bank statement. 

All funding documentation should be dated within 6 months of the time is it is received at the International Center and 

does not need to an original (a copy or scan is acceptable). 

Financial documents must show liquid assets that can be converted to cash 

DO NOT MAIL DEEDS, TRUSTS, TAX DOCUMENTS, SALARY STATEMENTS, ETC. 

Funding Sources: 

o Private Sponsor: A person who will support the educational and living expenses during your time at UCI. An 

original signed and dated letter is required along with the copy of bank statement. 

• Sample Text for Letter: 

“To Whom It May Concern, I (fill in name), (relationship to student), am willing and able to 

provide the educational and living expenses in the amount of ($$$$$) for (name of student), 

during their studies at UCI.” (Signature) (Print Name) (Date) 

o Government, Agency, or Corporate Fellowship: If an agency will be supporting you during your studies at UCI, you 

will be required to provide UCI with an award letter. This letter should clearly state the terms and conditions of 

your award (duration of award, visa conditions, types of expenses covered, etc.) 

o University Support: Your department has offered you funding during your time here at UCI. University support 

includes but is not limited to (fellowships, assistantships, grants, etc.) 

• You are not required to state the exact dollar amount your admitting department will provide you with, as 

the department will provide this information to the International Center directly. 

o Personal Funds: Provide a copy of a bank statement/letter in your name with the amount that you are providing 

for your studies at UCI. 

Fees listed on this form are subject to change. 

REQUIRED FUNDING FOR NEW GRADUATE STUDENT PROGRAMS - INCLUDES $17,000 FOR LIVING EXPENSES 

*Deduct $17,000 from the amount below for current required estimate of tuition/fees for 2014-2015. Fees subject to change 

without notice. 

ALL GRADUATE: 

$47,657* 

M. BUSINESS ADMINISTRATION: 

$64,091* 

LAW: 

$70,804* 

M. PUBLIC HEALTH: 

$50,414* 

ENGINEERING MANAGEMENT: 

$56,801* 

M. PUBLIC POLICY: 

$50,753* 

Advanced to Candidacy 

$32,555* 

M. PROFESSIONAL ACCOUNTANCY: 

$57,002* 

[ADD $10,000 FOR SUMMER START DATE]. 

Section Six: For F-1/J-1 Students Transferring from Another U.S. School (if applicable) 

This portion of the form is to be completed by students who are currently attending school in the United States in F-1/J-1 

student status. 

Take this form to your current institution’s international student office and have a student advisor (DSO/ARO/RO) complete 

this form so that your SEVIS record is transferred to UCI. 

You must arrange the appropriate release date with your current school. Based on the date of your transfer to UCI, is when 

your new visa document will be issued. UCI will not be able to issue you a new visa document until the SEVIS release date is 

entered by your current institution. 





SECTION ONE: PERSONAL INFORMATION 

LAST NAME: 

FIRST NAME: 

MIDDLE NAME [IF APPLICABLE]: UCI STUDENT ID #: 

ADMITTING UCI DEPARTMENT: 

DATE OF BIRTH [MM/DD/YYYY]: 

GENDER: MALE FEMALE PHONE NUMBER: 

BIRTHPLACE CITY: 

BIRTHPLACE COUNTRY: 

COUNTRY OF CITIZENSHIP: 

COUNTRY OF PERMANENT RESIDENCE: 

UCI EMAIL or UCINetID [REQUIRED]: 

E-MAIL ADDRESS: 

PERMANENT ADDRESS STREET ADDRESS [NO P.O. BOX ADDRESSES]: 

IN HOME COUNTRY 

[REQUIRED]: 

CITY: 

PROVINCE: 

POSTAL CODE: 

COUNTRY: 

LOCAL ADDRESS IN 

THE U.S. 

STREET ADDRESS: 

CITY: 

PROVINCE: 

[IF APPLICABLE]: POSTAL CODE: 

COUNTRY: 

SECTION TWO: VISA INFORMATION 

WHAT TYPE OF VISA WILL YOU BE APPLYING FOR? F-1 STUDENT J-1 STUDENT 

IF YOU ARE CURRENTLY IN THE U.S., WHAT IS YOUR CURRENT VISA STATUS? [COMPLETE ONLY IF IN U.S.]: 

F-1 OR J-1 STUDENT AT ANOTHER U.S. INSTITUTION [COMPLETE SECTION SIX] 

F-1 OR J-1 STUDENT CURRENTLY AT UCI [CONTINUE TO NEXT SECTION, AND DO NOT COMPLETE SECTION SIX] 

OTHER VISA [PLEASE ANSWER CHANGE OF STATUS QUESTIONS BELOW]: _________ 

IF YOU ARE NOT CURRENTLY AN F-1 OR J-1 STUDENT IN THE U.S., HOW WOULD YOU LIKE TO CHANGE YOUR 

IMMIGRATION STATUS TO F-1/J-1 STUDENT STATUS? [MARK ONLY ONE] 

INSIDE THE U.S. BY FILING A CHANGE OF STATUS APPLICATION WITH THE U.S. CITIZENSHIP AND IMMIGRATION SERVICES [USCIS] 

You will be contacted via email by an International Center Advisor for more information regarding change of status in the U.S. 

APPLYING FOR AN F-1 OR J-1 STUDENT VISA IN YOUR HOME COUNTRY 

SECTION THREE: DEPENDENT INFORMATION [IF APPLICABLE] 

WILL YOU HAVE DEPENDENT’S WITH YOU IN THE U.S.? YES NO [SKIP THIS SECTION] 

INCLUDE A COPY OF YOUR SPOUSE’S/CHILD(REN)’S PASSPORT BIOGRAPHICAL PAGE [REQUIRED]. 

LAST NAME: 

FIRST NAME: 

CITY OF BIRTH: 

COUNTRY OF BIRTH: 

DEPENDENT 1: COUNTRY OF CITIZENSHIP: 


RELATIONSHIP TO STUDENT: 

LAST NAME: 

FIRST NAME: 






LAST NAME: 

FIRST NAME: 










SECTION FOUR: MAILING INFORMATION 

EXPRESS MAIL – TO ARRANGE VISIT eShipGlobal TO PAY FOR EXPRESS MAILING: https://study.eshipglobal.com. 

YOU WILL NEED YOUR UCI STUDENT ID NUMBER, MAILING ADDRESS, E-MAIL ADDRESS, PHONE NUMBER, AND CREDIT CARD INFORMATION. 

SECTION FIVE: FUNDING INFORMATION [MARK ALL THAT APPLY] – 

SEE INSTRUCTIONS FOR EXACT DOLLAR AMOUNT REQUIRED BY YOUR SPECIFIC PROGRAM. 

*Insufficient funds will delay the processing of your F-1 I-20/DS-2019 visa document. Fees subject to change without notice. 

PRIVATE SPONSOR [REQUIRED: INCLUDE SIGNED AND DATED SPONSORSHIP LETTER AND FINANCIAL DOCUMENTS] 

GOVERNMENT FOUNDATION, AGENCY, OR CORPORATE FELLOWSHIP [REQUIRED: OFFICIAL AWARD LETTER] 

UNIVERSITY SUPPORT 

PERSONAL FUNDS [REQUIRED: BANK LETTER/STATEMENT] 

SECTION SIX: FOR F-1/J-1 STUDENTS TRANSFERRING FROM ANOTHER U.S. SCHOOL [IF APPLICABLE] 

(HIGH SCHOOL, COLLEGE, UNIVERSITY, LANGUAGE SCHOOLS, INCLUDING UCI EXTENSION) 

STUDENT’S LAST NAME: 

STUDENT’S FIRST NAME: 

INFORM THE INTERNATIONAL OFFICE AT YOUR CURRENT SCHOOL THAT YOU PLAN TO ATTEND UC IRVINE. PLEASE HAVE YOUR 

INTERNATIONAL STUDENT OFFFICE COMPLETE THE INFORMATION BELOW. 

IS THIS STUDENT IN VALID IMMIGRATION STATUS: YES 

PROGRAM COMPLETION DATE (MM/DD/YYYY): 

NAME OF DESIGNATED SCHOOL OFFICIAL (DSO/ARO/RO): 

SIGNATURE OF DESIGNATED SCHOOL OFFICIAL (DSO/ARO/RO): 

NO 

SEVIS RELEASE DATE (MM/DD/YYYY): 

EMAIL: 

PHONE NUMBER: 

INSTITUTION NAME AND ADDRESS: 

UC IRVINE F-1 PROGRAM: LOS214F01962000 • UC IRVINE J-1 PROGRAM: P-1-04818 

CHECKLIST FOR COMPLETING THE I-20/DS-2019 REQUEST FOR NEW GRADUATE STUDENTS 

MAILING OPTION SELECTED [SECTION FOUR] 

COPY OF BANK STATEMENTS/AWARD LETTERS UNLESS FUNDED BY UNIVERSITY [SECTION FIVE] 

COPY OF PASSPORT BIOGRAPHICAL PAGE 

F-1/J-1 STUDENT TRANSFER SECTION COMPLETE [IF TRANSFERRING FROM ANOTHER SCHOOL] 

COPIES OF CURRENT I-20/DS-2019 AND I-94 DOCUMENT [ONLY IF TRANSFERRING FROM ANOTHER SCHOOL] 

IF APPLICABLE: 

COPY OF DEPENDENT[S] PASSPORT BIOGRAPHICAL PAGE[S] 

I VERIFY THAT ALL INFORMATION PROVIDED IS TRUE TO THE BEST OF MY KNOWLEDGE. I VERIFY THAT I CAN MEET EXPENSES WHILE ATTENDING UC IRVINE. I 

UNDERSTAND THAT THE INTERNATIONAL CENTER WILL ONLY PROCESS COMPLETE APPLICATIONS FOR AN I-20/DS-2019. IT IS MY RESPONSIBLITY TO NOTIFY MY 

ADMITTING ACADEMIC DEPARTMENT OF ANY CHANGES TO MY ACADEMIC PLANS AT UCI. 

ADMITTED STUDENT’S NAME [PRINT]: 

ADMITTED STUDENT’S SIGNATURE: 

DATE [MM/DD/YYYY]:

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