International_Visitor_Information_Form.doc

Information Requirements for International Visitors

1. Visitor’s Full Name (official) (Last, First, Middle):

2. Gender:

3. Date of Birth (Day/Month/Year):

4. Place of Birth:

5. Citizenship:

6. Passport Number:

7. Date Passport Issued:

8. Date of Passport Expiration:

9. U.S. Naturalization No.:

(if a naturalized citizen)

10. U.S. Naturalization Date:

(if a naturalized citizen)

11. Visitor’s Organization Name:

12. Organization Address:

13. Organization Telephone Number:

14. Visitor’s Position/Title within the

Organization:

*Include a copy of the visitor’s passport that includes picture and personal information.