Intensive English Program Student Document Request

Intensive English Program Student Document Request
First Name*
Middle Name
Last Name (Family Name)*
Telephone*
Email*
Are you currently enrolled in the Intensive English Program?*

YesNo
Student ID Number*
Last Day of Attendance*

MonthDayYear
Date
Which document(s) do you need?*

Enrollment Verification Letter (current session)Enrollment Verification Letter (all sessions)Grade History Report (includes dates and grades for all courses taken)Financial Guarantee Extension LetterTuition Payment StatementNo Social Security Number Letter (used to confirm that you are not eligible to obtain a Social Security number)Bank Letter (sometimes needed to open a bank account in the U.S.)I-20 travel SignatureOther
I need a Tuition Payment Statement for:

Current SessionAll SessionsJanuary-FebruaryMarch-AprilMay-JuneJuly-AugustSeptember-OctoberNovember-December
List the session(s) to be included in the Scholarship Extension Letter*

January-FebruaryMarch-AprilMay-JuneJuly-AugustSeptember-OctoberNovember-December
I am planning to leave the United States on Date and I will return to the United States on Date . Your electronically-signed I-20 will be e-mailed to you.
*Document requests will be processed within 2 business days.
Number of copies*

12345
Indicate the method of distribution*

Pick up by studentPick up by another personMail my document(s)Email my document(s)
By completing this section you are authorizing the Rice University Language Programs to release the information indicated on this request to the following person or agency.
By completing this section you are authorizing the Rice University Language Programs to release the information indicated on this request to the following person or agency.
Name/Attention To*
Email*
First and Last Name of Person to Pick Up Document(s)*
Name/Attention To*
By completing this section you are authorizing the Rice University Language Programs to release the information indicated on this request to the following person or agency.
Company/Agency (if any)
Delivery Address*
City*
State*
Province/Region (if any)
Country*
ZIP Code (Postal Code)*
Date

MonthDayYear
Date
Should be Empty: