Sevis Registration

SEVIS REGISTRATION

Please complete this form and answer all fields ONLY after you have arrived in the United States. If you have questions or require additional assistance, please contact us.
PLEASE NOTE: All fields with a "*" must be filled out!

PERSONAL INFORMATION

Student Name

First Name

Last Name

DS2019 Number

Date of Birth

YYYY

US Arrival Date

YYYY

Country of Origin

Student Email Address

U.S. Mobile/Cell Phone Number

(###)

###

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EMPLOYER INFORMATION

Employer Name

Employer Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Employer Phone

(###)

###

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Employer E-mail (or Personal Email)

HOUSING INFORMATION