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I-20 Request for Extension of Program of Study

1. Family Name*
2. First Name*
3. Middle Name
4. Student Number*
5. E-mail Address*
6. Phone Number*
7. Street Address*
8. City*
9. State*
10. Zip Code*
11. Year you began at UCM*
12. Major*
13. Degree*
BA    BS    BSBA    BFA    BSE    MA    MS    MBA    MSE   
14. Visa Expiration Date*
15. Passport Expiration Date*

In order for your request to be processed you must submit a supporting letter from your Academic or Graduate Advisor.

16. New anticipated completion date of program*
17. Comments