Exchange Visitor Information

First Name

Must match passport name

Last Name

Must match passport name

Gender (as seen on passport)

Telephone Number

Email Address

Passport Number

Passport Expiration Date

Country of Passport Issue

Date of Birth

City of Birth

Country of Birth

Country of Citizenship

Country of Permanent Residence

Permanent Address

Address Line 1

City

State/Province/Territory

Country

Zip/Postal Code

Representative Information

Who is filling out this application?

State the relationship between the Exchange Visitor and the person filling out the application.

Representative's Last Name

Representative's First Name

Representative's Telephone Number

Representative's Email Address

Immigration and Legal Information

Have you ever been to the U.S. before?

If "Other", state the visa type(s).

If "J-1 Visa", state the category of the visa (e.g. Work & Travel, Intern, Trainee, Student, etc) and the Visa Dates.

Have you ever had a visa application refused?

If "Yes", please explain.

Have you ever been denied entry to the U.S. before?

If "Yes", please explain.

Education Information

School/University

Type of Degree

Other Degree

Field of Study

Country

Start Date

End Date (Expected End Date if still attending)

Employment/Internship Experience

Company/Organization Name

Position

Field of Employment/Internship Experience

Country

Start Date

End Date

Additional Details

Skills

Languages

Awards

J-1 Program Information

What is the field of your proposed J-1 program?

In which city would you like to complete your proposed J-1 program?

Desired length of J-1 Program (in months)

Desired Start Date of J-1 Program

Provide a brief description of your objectives for your proposed J-1 Program.

Do you have a J-1 Program already arranged in the United States?

Proposed Host Organization

Additional Information

How did you hear about us?

Name of Friend, Family, Host Organization, or University that referred you.

If your application is accepted, would you like to request expedited processing of your J-1 Sponsorship Application?

Do you need a J-2 visa for any of your dependents? (e.g. spouse, child, etc.)

Is there anything else that you would like to tell us about your application?

Agreement

I certify that all information provided to me, or my representative, on this application is factually correct and up-to-date. I understand that any false or omitted information may lead to rejection of my application. I will provide updated information to International Arts & Artists as necessary.

Yes