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I-20_Zhu_Qi_N0026116107_1501183095708.pdf - Department of...

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SEVIS ID: N0026116107 SCHOOL INFORMATION PROGRAM OF STUDY FINANCIALS REMARKS SCHOOL ATTESTATION STUDENT ATTESTATION Department of Homeland Security I-20, Certificate of Eligibility for Nonimmigrant Student Status U.S. Immigration and Customs Enforcement OMB NO. 1653-0038 SURNAME/PRIMARY NAME Zhu GIVEN NAME Qi Class of Admission PREFERRED NAME Qi Zhu PASSPORT NAME Zhu Qi F-1 COUNTRY OF BIRTH CHINA COUNTRY OF CITIZENSHIP CHINA DATE OF BIRTH 06 AUGUST 1993 ADMISSION NUMBER ACADEMIC AND LANGUAGE FORM ISSUE REASON INITIAL ATTENDANCE LEGACY NAME SCHOOL NAME California Institute of Integral Studies California Institute of Integral Studies SCHOOL ADDRESS 1453 Mission Street, San Francisco, CA 94103 SCHOOL OFFICIAL TO CONTACT UPON ARRIVAL Yuwen Chiu Associate Director of Admissions SCHOOL CODE AND APPROVAL DATE SFR214F00860000 28 JANUARY 2003 EDUCATION LEVEL BACHELOR'S MAJOR 1 Multi-/Interdisciplinary Studies, Other 30.9999 MAJOR 2 None 00.0000 PROGRAM ENGLISH PROFICIENCY Required ENGLISH PROFICIENCY NOTES Student is proficient EARLIEST ADMISSION DATE 01 AUGUST 2017 START OF CLASSES 31 AUGUST 2017 PROGRAM START/END DATE 31 AUGUST 2017 - 31 AUGUST 2018 ESTIMATED AVERAGE COSTS FOR: 12 MONTHS STUDENT'S FUNDING FOR: 12 MONTHS Tuition and Fees $ 29,106 Personal Funds $ 0 Living Expenses $ 30,000 Funds From This School $ Expenses of Dependents (0) $ family- Xuemin Yang and Weiran Zhu $ 65,305 fees $ 645 On-Campus Employment $ TOTAL $ 59,751 TOTAL $ 65,305 I certify under penalty of perjury that all information provided above was entered before I signed this form and is true and correct. I executed this form in the United States after review and evaluation in the United States by me or other officials of the school of the student's application, transcripts, or other records of courses taken and proof of financial responsibility, which were received at the school prior to the execution of this form. The school has determined that the above named student's qualifications meet all standards for admission to the school and the student will be required to pursue a full program of study as defined by 8 CFR 214.2(f)(6). I am a designated school official of the above named school and am authorized to issue this form. X DATE ISSUED PLACE ISSUED SIGNATURE OF: Yuwen Chiu, Associate Director of Admissions 27 July 2017 San Francisco,CA I have read and agreed to comply with the terms and conditions of my admission and those of any extension of stay. I certify that all information provided on this form refers specifically to me and is true and correct to the best of my knowledge. I certify that I seek to enter or remain in the United States temporarily, and solely for the purpose of pursuing a full program of study at the school named above. I also authorize the named school to release any information from my records needed by DHS pursuant to 8 CFR 214.3(g) to determine my nonimmigrant status. Parent or guardian, and student, must sign if student is under 18.
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