autumn quarter 2014 summer quarter 2014

international student payment form

Instructions:

1. Print carefully and clearly so that we can accurately process your payment. 2. Return this form along with the $300 New Student Enrollment and Orientation Fee (NSEOF). Submit this form to the Registrars Processing Center by
May 1, 2014, for international freshmen or by the date specified on the Enrollment Confirmation Instructions for all other students. If you have not yet received the Enrollment Confirmation Instructions by postal mail, you may confirm enrollment without it. Follow all other instructions and submit all other forms.

3. Submit your NSEOF payment by postal mail or online by reviewing the payment options at admit.uw.edu/Welcome/International/Confirm. Indicate
below which payment option you have selected.

4. To request immigration documents for study at the UW, review the instructions online, then complete and return the I-20 Request Form and the
Statement of Financial Responsibility. We recommend that you submit the forms at the same time as the NSEOF confirmation payment, but you may send them separately if you prefer. There is no specific deadline for submitting the I-20 Request Form and supporting documents, but immigration documents cannot be created until the UW receives them. If sending documents by express mail: University of Washington Registrars Processing Center 1410 NE Campus Parkway 225 Schmitz Hall Seattle WA 98195 USA If sending documents by regular mail: University of Washington Registrars Processing Center Box 355850 Seattle WA 98195-5850 USA

I accept my offer of admission to the Seattle campus of the University of Washington and wish to confirm my enrollment.

STUDENTS NAME

Last (Family) name

First (Given) name

Middle name

|
DATE OF BIRTH

|
Month Day

|
Year

UW STUDENT NUMBER as shown on the Enrollment Conrmation instructions

or at admit.uw.edu/Welcome/International/Connecting.

Quarter of Admission:

Autumn 2014

Summer 2014

I have paid the $300 New Student Enrollment and Confirmation Fee (NSEOF) by Bank check/draft/money order (included with this form) Peer Transfer (paid online) Web check (paid onlineFreshman only)
Important: Paying the NSEOF is the only way to confirm your enrollment at the Seattle campus of the UW. Enrolling or participating in any other UW program

for example, on-campus housing, the Honors Program, admission to a department does not confirm your enrollment at this campus.

STUDENT SIGNATURE

Disability information The UW is committed to providing access and reasonable accommodation in its services, programs, activities, education and employment for individuals with disabilities. To request disability accommodation, contact Disability Resources for Students (DRS), which serves as a partner in fostering an inclusive and equitable environment for all UW students: depts.washington.edu/uwdrs (Web); uwdss@uw.edu (email); (206) 543-8924 (Voice); (206) 206-543-8925 (TTY).
Universit y of Washington Registrars Processing Center 1410 NE Campus Pk w y 225 Schmit z Hall Box 355850 Seat tle WA 98195 -5850
ISPF.SUM/AUT 2061442 / 03.13.2014

Do you have a physical or mental impairment which substantially limits one or more major life activities such as seeing, hearing, speaking, walking, learning, working, etc.? Yes No Your answer will be used by the State of Washington for planning purposes. It will also be used by UW Disability Resources for Students to provide you with information about its services. This information will be held in the strictest condence.