Examples of eligible visa categories: F1, F2, J1, J2, H1B, H4 and G4
Name of School/Agency/International Organization
Comments ( Enter visa category, and expiration date (if applicable). If expiration date has past,
include pending extension receipt number from I-797. Ex: H1B, receipt WAC123456789
Note: You must be a Maryland resident in order to fill out this form.
If you have any problems with this form, email firstname.lastname@example.org.