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Visa Document Request Form

Please fill out the Visa Document request form below and submit by:
May 31st for fall entrants/September 30th for spring entrants

All New International Students:
Please email or fax the ID page from your passport to our office. You can fax it to 413-538-3385 or email it to jmedina@mtholyoke.edu

International Students Currently in the United States:
Please mail, email or fax our office photocopies of the documents listed below:

ID page from your passport
Visa stamp in passport
Pages 1& 3 of your I-20 form (for F-1 students) or page 1 of the DS-2019 form (for J-1 students)
Transfer Release Form (linked on the left)

Mail to:
McCulloch Center for Global Initiatives
Dwight Hall
Mount Holyoke College
50 College Street
South Hadley, MA 01075 USA

Or Fax them to 413-538-3385 or by email to jmedina@mtholyoke.edu

Last (Family) Name as written in your passport *

First (Given) Name as written in your passport *

Country of Citizenship *

Country of Residence *

Country of Birth *

City of Birth *

Current Street Address *

City *

Postal Code *

Country *

MHC Email (if known)

Alternate Email *

Current Telephone *

Permanent Street Address (if different from current address)

Permanent City

Permanent Postal Code

Permanent Country

Permanent Telephone (if different from current telephone)

Passport Issued by *

Are you currently studying in the US? *

If yes, in what visa status

Have you ever traveled to the US before? *

If yes, in what visa category?

If you are currently in the US, will you be traveling outside of the US before enrolling at MHC?

Date of Planned departure to the US? *

Month

Day

Year

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Visa Document Request Form

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