SHEFA

SHEFA Application form - Page one; Student Data

IMPORTANT NOTE: You MUST complete all 4 pages of the application form in order to acquire your application ID. This number MUST be referred to in all correspondence regarding your application. INCOMPLETE SUBMISSIONS WILL NOT BE RECOGNIZED.

Please note that your email address must be unique. We no longer allow shared email addresses.
If you have any problems with the online application, please contact webmaster@saipanshefa.com

* = Required Fields

Please enter a new login name for your account.
Letters and Numbers ONLY, please. * :

Please enter a new password (minimum 4 characters) for your account.
Letters and Numbers ONLY, please : *

Please re-enter your new password: *

Last Name *

First Name *

Middle Initial

Suffix (Jr. II, etc...)

Mailing Address *

City *

State *

Zip / postal code *

Country *

Permanent Saipan Address *

Social Security Number *

Phone (xxx-xxx-xxxx) *

Email *

Citizenship *

Gender*

Male Female

Date of Birth*

Place of Birth - city *

Place of Birth - State *

Place of Birth - Country *

Are you a permanent Saipan resident?*

Yes No

Village Residing*

Valid Sapan Municipal ID #:

Ethnicity*

Marital Status*

If married, Name of Spouse:

Number of Dependents:

Employer Name

Employer Address

Employer City

Employer State

Employer Zip / postal code

Employer Country

Employer Phone (xxx-xxx-xxxx)

Spouse's Employer Name

Spouse's Employer Address

Spouse's Employer City

Spouse's Employer State

Spouse's Employer Zip / postal code

Spouse's Employer Country

Spouse's Employer Phone (xxx-xxx-xxxx)

Name of Parents/Guardian

Parents/Guardian Address

Parents/Guardian City

Parents/Guardian State

Parents/Guardian Zip / postal code

Parents/Guardian Country

Are you or your parents receiving housing benefits?

Yes No

Do you or your parents have repatriation benefits?

Yes No

Name of High School attended:*

High School/Graduation Date:*