INFORMATION NEEDED FOR F-1 VISA APPLICATION

First Name of Student (as shown in passport):

Middle Name of Student (as shown in passport):

Last Name of Student (as shown in passport):

Any other Last Names used (maiden name, previous married names, aliases, etc.):

Student's passport number:

City where Student's passport was issued:

State or Province where Student's passport was issued:

Country where Student's passport was issued:

Date when Student's passport was issued:

Expiration date of Student's passport:

Student's Date of Birth:

Student's City of Birth:

Student's Country of Birth:

Student's State or Province of Birth:

Student's Country of Nationality:

Student's sex (Male or Female):

Student's National Identification Number (from country of nationality):

Student's home address (include street, apartment number, city, state/province, country, postal code):

Student's home telephone number:

Student's home fax number:

Student's business telephone number:

Student's business fax number:

Student's cell phone number:

Student's pager number:

Student's marital status (married, never married, widowed, divorced, separated):

Student's current spouse's full name:

Student's current spouse's date of birth:

Name of Student's current employer or school:

Address of Student's current employer or school:

Student's current occupation:

Is Student currently a student?

Is Student currently retired?

When does the Student intend to arrive in the U.S.?

Student's e-mail address:

At what address will Student stay in the U.S.?

Name of person in the U.S. with whom Student will stay:

Home telephone number of person in the U.S. with whom Student will stay:

Business telephone number of person in the U.S. with whom Student will stay:

Cell phone number of person in the U.S. with whom Student will stay:

How long does Student intend to stay in the U.S.?

What is the purpose of the trip to the U.S.?

Who will pay for the trip to the U.S.?

Has Student ever been to the U.S. before?

If yes, how many times?

List the dates of entry and exit to and from the U.S. for all previous visits:

Has Student ever been issued a U.S. visa before?

If yes, how many times?

List dates visas were issued, location of consulate/embassy where visas were issued and types of visas:

Has Student ever been refused a visa to the U.S.?

If yes, how many times was Student refused?

List dates, locations of consulate/embassy where application was refused, and type of visa applied for:

Does Student intend to work in the U.S.?

If yes, give name and address of U.S. employer:

Does Student intend to study in the U.S.?

If yes, give name and address of U.S. school:

Will anyone travel with the Student to the U.S.?

If yes, how many persons?

List names and relationships of persons who will travel with Student to the U.S.:

Has Student ever had a U.S. visa canceled or revoked?

Has anyone ever filed an Immigrant Visa Petition for the Student (I-130, I-140, etc.)?

If yes, who filed it?

Is the Student's current spouse in the U.S.?

If yes, what is the spouse doing (visiting, studying, working, etc.)?

Is Student's current spouse a permanent resident?

Is Student's current spouse a U.S. citizen?

Is Student's father in the U.S.?

If yes, what is Student's father doing (visiting, studying, working, etc.)?

Is Student's father a permanent resident?

Is Student's father a U.S. citizen?

Is Student's mother in the U.S.?

If yes, what is Student's mother doing (visiting, studying, working, etc.)?

Is Student's mother a permanent resident?

Is Student's mother a U.S. citizen?

Is Student's fiance in the U.S.?

If yes, what is Student's fiance doing (visiting, studying, working, etc.)?

Is Student's fiance a permanent resident?

Is Student's fiance a U.S. citizen?

Does Student have any son, daughter, brother or sister who lives in the U.S. or has permanent resident status or is a U.S. citizen?

If yes, state what type of relationship, the person's status, and what the person is doing in the U.S.:

Has Student ever been arrested?

Has Student ever been charged with a crime?

Has Student ever been convicted of a crime?

Has Student ever unlawfully distributed or sold illegal drugs, been a prostitute, or hired a prostitute?

Has Student ever been refused admission to the U.S. or been the subject of a deportation hearing?

Has Student ever helped anyone enter the U.S. through fraud or misrepresentation or other unlawful means?

Has Student ever attended a U.S. public elementary school or public high school in F status without reimbursing the school?

Is Student a member of any terrorist organization or does Student intend to engage in terrorist activities?

Has Student ever violated the terms of a U.S. visa or been unlawfully present in the U.S. or been deported from the U.S.?

Has Student ever withheld custody of any U.S. citizen child outside the U.S. or voted in the U.S. or renounced U.S. citizenship?

Has Student ever suffered from a communicable disease (such as AIDS or tuberculosis) or a dangerous physical or mental disorder or drug abuse or drug addiction?

Does Student belong to any clan or tribe?

If yes, please list all clans or tribes:

What is Student's father's full name?

What is Student's mother's full name?

List all countries which Student has entered in the last 10 years AND the year Student visited each country:

Last all countries which have ever issued Student a passport:

Has Student ever lost a passport or had a passport stolen?

List the following information for Student's LAST TWO employers (NOT INCLUDING CURRENT EMPLOYER):

List all professional, social or charitable organizations to which Student has ever belonged, contributed or worked for, and indicate for each one whether Student belonged to the organization, contributed to the organization or worked for the organization:

Does Student have specialized skills or training in firearms, explosives, nuclear technology, biological or chemical areas? If yes, which one(s)?

Has Student ever performed military service?

If yes, state the name of the country, branch of service, rank/position, military specialty and dates of service:

Has Student ever been a participant or victim of armed conflict?

If yes, explain:

List all schools which Student has ever attended (include Name, Address, Phone, Course of Study, Dates of Attendance):

Has Student already made travel arrangements?

If yes, state arrival/departure dates, flight information, specific locations Student will visit and contact information for each location:

Please return completed questionnaire to:

Vickerstaff Law Office, PSC
1930 Bishop Lane Suite 410
Louisville, KY 40218
Telephone: (502) 442-2039 or (888) 832-2944
Fax: (502) 491-0719
Contact Us

Louisville immigration attorney serving immigrant, refugee, asylum, and out-of-status clients in Kentucky, Ohio, and Indiana, including Paducah, Frankfort, Lexington, Owensboro, Bowling Green, and Shelbyville KY, Cincinnati OH, and Indianapolis, Evansville, Anderson, Madison, Bedford, and Bloomington IN.