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Personal Information
Full Name
E-mail
Sex	Male  Female
Address (India) Line 1
Address Line 2
City
State
Postal Code
Home Phone
Itinerary Information
Departure Date (mm/dd/yy)
Departure Airport
Airlines (while departing from India)
Flight no (while departing from India)
Port of Entry in USA
Arrival Date in USA (mm/dd/yy)
Arrival Time in USA (hh:mm AM/PM)
Last Departing Airport
Airlines (for reaching Lubbock)
Flight no (for reaching Lubbock)
Arrival Date in Lubbock (mm/dd/yy)
Arrival Time in Lubbock (hh:mm AM/PM)
US Contact (if any)
Additional Information
Department
Program (MS/PhD/UG)
Temporary Accommodation required ?	Yes  No
Airport Pickup required ?	Yes  No

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