International Student Questionnaire

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INTERNATIONAL/UNDOCUMENTED STUDENTS: Once your application is completed at www.cccb.edu/apply, please complete this form for us to better get to know you.

First Name *

Last Name *

Birthplace (City, State/Province if applicable) *

Mailing Address *

City/Town/Village *

State/Province *

Country *

Postal Code *

Mobile/Phone Number *

Are you currently living in the United States? *

Yes

What type of visa do you currently hold? *

F-1

I do not currently hold a Visa

Other

Passport Number *

Are there any family members coming to the US with you? *

Yes

Maybe

How many children coming to the US with you? *

How many adults (not counting yourself)? *

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