Fillable Printable Application for the International Student Identity Card

Application for the International Student Identity Card

The Hope-Geneva Bookstore is an authorized agent for the official

International Student/Teacher I.D. Cards. Please complete the

following steps to obtain a card:

1.Fill out the application form on the reverse side.

2.Have your college or university's registrar's office

complete the School Declaration below.

3.Provide a recent head shot photograph*

of passport quality.

4.Present proof of date-of-birth to bookstore cashier:

[ ] Driver's License [ ] Passport [ ] Other __________

5.Turn in the completed form, photograph and $25.00 card

fee to the bookstore. Please make checks payable to:

Application

for the

International Student Identity Card

International Teacher Identity Card

COUNCIL

School Declaration

Hope-Geneva Bookstore

Name of School:

I hereby certify thatthe applicant is a degree-seeking

student at this institution and is registered during the

current academic year.

DateRegistrar's Signature

School Imprint

Here

Return this form to the Hope-Geneva Bookstore. I.D. Cards are normally

available within 48 hours.

*Photocopies of photograhs are NOT ACCEPTABLE.

NOTE: Some age restrictions may apply on certain student and youth discounts.

Maximum

Photo

Size

1-1/8” x 1-3/8”

not larger than

International Identity Card Application

The following application form has been produced to be read by image scanning technology so please

keep a few things in mind while filling out this application:

1. Please print in CAPITAL BLOCK LETTERS

2. Please use BLACK INK

3. Please keep your printing inside of the boxes provicec

(please see eligibility requirements and questionnaire on reverse)

Shade circles like this:

Not like this:

Which card are you applying for? (Use one box only):

StudentTeacher

Citizenship

First Name

Last Name

Number and Street Address (U.S. Addresses Only)

CityStateZip Code

Date of Birth(Area Code) Telephone Number

E-mail

School Name

Permanent Address (if different from above)

Number and Street

CityStateZip Code

(Area Code) Telephone Number

International Identity Card #

Date of Issue

For office use only

I hereby certify that this information is true and

understand that any false statements on my part may

result in the forteiture of any benefits associated with

the card.

Signature