Request for Form I-20

I certify that the information provided here is correct and complete. I understand I will be responsible for adhering to all UMW tuition, fees, room and board, and health insurance payment schedules. I acknowledge I am required to have insurance and the fee is non-refundable if I leave the UMW under any circumstance.

Last Name	First Name	Date of Birth (mm/dd/yyyy)	City and Country of Birth	Relationship

I-20 Request Form

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