International Identity Card Application

APPLICATION FOR AN

INTERNATIONAL STUDENT/TEACHER IDENTITY CARD

PLEASE VISIT THEIR WEBSITE AT:

WWW.MYISIC.COM

YOU WILL BE ABLE TO VIEW THE HEALTH INSURANCE PLAN (WHICH CAN

ONLY BE USED OUTSIDE OF THE UNITED STATES). YOU MAY ALSO WISH

TO VIEW THE MANY DISCOUNTS AVAILABLE TO CARD HOLDERS.

AND…REMEMBER, IT IS ALSO ANOTHER FORM OF PHOTO ID.

IF YOU DECIDE YOU WOULD LIKE TO PURCHASE THIS CARD, YOU WILL

NEED THE FOLLOWING:

APPLICATION (ATTACHED)

PASSPORT SIZE PHOTO

CASH OR CHECK/MONEY ORDER FOR $25.00

(made out to the College of Staten Island – NO CHARGES ACCEPTED)

CURRENT PROOF OF STUDENT/TEACHER STATUS

(copy of your ID card from home school)

YOU MAY VISIT THE CENTER FOR INTERNATIONAL SERVICE AT THE

COLLEGE OF STATEN ISLAND, BUILDING 2A ROOM 206 OR

CALL 718-982-2100. YOU MAY APPLY FOR YOUR CARD IN PERSON, OR,

YOU MAY MAIL EVERYTHING TO US AND WE WILL MAIL YOUR CARD TO

YOU UPON COMPLETION.

THANK YOU FOR YOUR INTEREST IN THE ISIC CARD.

Center for International Service, College of Staten Island/CUNY,

2800 Victory Boulevard, Building 2A, Room 206, Staten Island, NY 10314

Phone: 718-982-2100

www.csi.cuny.edu/international

International Identity Card Application

1. Please print in CAPITAL BLOCK LETTERS Shade circles like this: ●

2. Please use BLACK INK NOT like this: ⊗ or √

3. Please keep your printing inside of the boxes provided

(Please see eligibility requirements and questionnaire on reverse)

Which card are you applying for? (use on box only): О Student Ο Teacher

Citizenship

First Name Last Name

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

City State Zip Code

Date of Birth (Area Code) Telephone Number School ID #

E-mail

Month Date Year

School Name

Permanent Address (if different from above)

Number and Street

City State Zip Code

(Area Code) Telephone Number

I hereby certify that this information is true and

understand that any false statements on my part

may result in the forfeiture of any benefits

associated with the card. Signature ________________________________________

(OVER)

International Identity Card # Date of Issue

FOR OFFICE USE ONLY

You Will Need: 1. Proof of student/youth/teacher status (see below)

2. One Photo (Passport size)

3. I.D. Card Fee $25.00 cash or check

(payable to The College of Staten Island)

Students: Photocopy of school ID (must be validated for current academic year)

Teachers: Photocopy of Faculty ID (must be validated for current academic year)

Note: Some age restrictions may apply on certain student discounts.