When all admission criteria has been appropriately met, a copy of this form will be attached to the Certificate of Eligibility. Both must be shown to the U.S. Consulate for issuance of the visa .
Fees are subject to change without notice.
This is to certify that I have read the information furnished by this applicant on this form and that it is true and accurate. The above funds are available. I certify that the above information is true and correct. I also understand that falsifying this document could result in my admission to Kentucky State University being rescinded. It is the policy of Kentucky State University not to discriminate against any individual in its educational programs, activities, or employment on the basis or race, color, national origin, sex, disability, veteran status, age, religion, or marital status.