8
Email Address: ________________
Email Address:
2nd Child’s Information\nFull Name (as in passport): ________________ First/Given Name ________________ Middle Name (if any) ________________
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First/Given Name
Middle Name (if any
Last/Family Name ________________ First/Given Name ________________
Last/Family Name
Date of Birth ________________ Gender: ☐ Male ☐ Female ☐ Female
mm/dd/yyyy Place of Birth ________________ , ________________ , ________________ Province/State ________________ , ________________ Country ________________
mm/dd/yyyy
Gender
Gender
City ________________ Country of Citizenship ________________ Country of Permanent Residence ________________
City
Province/State
Country
Email Address: ________________
Country of Citizenship
Country of Permanent Residence
3rd Child’s Information\nFull Name (as in passport): ________________ First/Given Name ________________ Middle Name (if any) ________________
Email Address
Last/Family Name ________________ First/Given Name ________________
Date of Birth ________________ Gender: ☐ Male ☐ Female ☐ Female
Last/Family Name
First/Given Name
Middle Name (if any
mm/dd/yyyy Place of Birth ________________ , ________________ , ________________ Province/State ________________ , ________________ Country ________________
mm/dd/yyyy
Gender
Gender
City
Province/State
Country
Country of Citizenship
Country of Permanent Residence
City ________________ Province/State ________________
City of Citizenship ________________ Country of Permanent Residence ________________
Country of Citizenship ________________ Country of Permanent Residence ________________
Email Address: ________________
Email Address
Note: For additional children, please copy this section and submit as a separate page with the above requested information.
Required Documentation to be Submitted with this Form
☐ Copy/Scan of Passport Identification Pages (for yourself and any accompanying dependents)
Copy/Scan of Passport Identification Pages (for yourself and any accompanying dependents
Copy/Scan of Proof of Financial Support or Bank Statement
☐ Copy/Scan of Proof of Financial Support or Bank Statement
Curriculum Vitae or Resume
☐ Curriculum Vitae or Resume
Copy/Scan of Transcripts of highest degree, only if teaching at Kentucky State University
☐ Copy/Scan of Transcripts of highest degree, only if teaching at Kentucky State University
If already in the United States, also include the following:
Copy/Scan of current/most recent Visa Stamp (for yourself and any accompanying dependents
☐ Copy/Scan of current/most recent Visa Stamp (for yourself and any accompanying dependents)
Copy/Scan of I-94 (for yourself and any accompanying dependents
☐ Copy/Scan of I-94 (for yourself and any accompanying dependents)
Copy/Scan of current/previous DS-2019’s, I-20’s, I-797 Approval Notices (for yourself and any accompanying dependents
☐ Copy/Scan of current/previous DS-2019's, I-20's, I-797 Approval Notices (for yourself and any accompanying dependents)
By signing below, I attest that all information I provided is accurate and true
International Applicant Signature
Date
International Applicant Signature: ________________ Date: ________________