8

Email Address: ________________

2nd Child’s Information\nFull Name (as in passport): ________________ First/Given Name ________________ Middle Name (if any) ________________

Last/Family Name ________________ First/Given Name ________________

Date of Birth ________________ Gender: ☐ Male ☐ Female ☐ Female

mm/dd/yyyy Place of Birth ________________ , ________________ , ________________ Province/State ________________ , ________________ Country ________________

City ________________ Country of Citizenship ________________ Country of Permanent Residence ________________

Email Address: ________________

3rd Child’s Information\nFull Name (as in passport): ________________ First/Given Name ________________ Middle Name (if any) ________________

Last/Family Name ________________ First/Given Name ________________

Date of Birth ________________ Gender: ☐ Male ☐ Female ☐ Female

mm/dd/yyyy Place of Birth ________________ , ________________ , ________________ Province/State ________________ , ________________ Country ________________

City ________________ Province/State ________________

City of Citizenship ________________ Country of Permanent Residence ________________

Country of Citizenship ________________ Country of Permanent Residence ________________

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)

If already in the United States, also include the following:

☐ 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