COMPLETE THIS FORM ONLY IF FAMILY MEMBERS (WIFE, HUSBAND, OR CHILDREN UNDER AGE 21) WILL BE ACCOMPANYING YOU TO THE UNITED STATES OR IF YOUR FAMILY MEMBER(S) REQUIRE(S) AN I-20 OR DS-2019 TO APPLY TO CHANGE VISA STATUS TO F-2 OR J-2. Unless they have U.S. citizenship, all family members must carry their own I-20 or DS-2019 Forms and apply for F-2 or J-2 visas. Provide the following information for each dependent. Use an additional sheet of paper if needed. Proof of additional funds is required in the amount of $6,000/year for a spouse and $4,000/year for each child for F-2 dependents, and $600/month for a spouse and $350/month for each child for J-2 dependents. Information provided must match passports.
Visitors on J-2 visas are required to have health insurance coverage and visitors on F-2 visas are strongly encouraged to have health insurance. You will find details on the health insurance requirement on the Health Insurance and Immunizations web page. Dependents do not need to arrive and depart at the same time as the primary F-1 or J-1 visa holder. They may enter later and leave earlier than the primary. However, proof of funding for dependents must include the entire stay of the primary.
An e-mail address for each dependent is required by the U.S. Department of State. If a dependent does not have an e-mail address, you may substitute your own e-mail address.
You will not be able to save this form and continue later. Please be prepared to upload passports for each dependent that will be accompanying you while you study at Cal Poly.