VISITING SCHOLARS PROGRAM APPLICATION

Transcription

1 VISITING SCHOLARS PROGRAM APPLICATION INSTRUCTIONS Please complete all sections and enter not applicable or N/A as needed. Submit your application along with the other required documents as an attachment to an addressed to Any questions about this application form or the Visiting Scholars Program should be directed to Erika Cuevas at BIOGRAPHICAL INFORMATION last/family name first/given name full middle name (if applicable, NO initials) Date of Birth City of Birth Marital Status Country of Birth Country of Citizenship Country of Permanent Residence *If scholar has dual citizenship, list country of passport in use for this visit. Gender Proposed Arrival Date Proposed Departure Date Current Occupation Title at Home Institution Name of Home Institution Type of Institution CONTACT INFORMATION Primary Mobile Phone (+country code) Daytime Phone (+country code) Evening Phone (+country code)

2 VISITING SCHOLARS PROGRAM APPLICATION CURRENT MAILING ADDRESS Address Line 1 City Address Line 2 State/Province Postal Code PERMANENT ADDRESS Address Line 1 City Address Line 2 State/Province Postal Code CURRENT/PREVIOUS U.S. VISA STATUS (IF APPLICABLE) Have you previously been in the U.S. in J-1 or J-2 status? Are you currently in the U.S.? *If you are not currently in the U.S., please continue to the next section. What is your current immigration status? What was the date of your last arrival in the U.S.? What period does your current immigration status cover? What is the expiration date (if any) on your I-94? What is your current U.S. postal address? Address Line 1 City Address Line 2 State/Province Postal Code

3 LANGUAGE PROFICIENCY VISITING SCHOLARS PROGRAM APPLICATION The U.S. Department of state has mandated that J-1 exchange visitors including short-term scholars, research scholars, professors, and specialists have sufficient English proficiency (22 CFR 62.10(a)(2)). The English proficiency requirement can be satisfied by submitting documentation of at least one of the following: 1. Copy of diploma/degree from U.S. or foreign institution where the instruction occurred in English. If diploma/degree is more than 15 years old the Center for Global Education may require additional details or documentation to show continued use of English. 2. A signed letter from an academic institution or English curriculum school that is internationally recognized that states the prospective visitor s level of English proficiency. This letter cannot be from the UW- Whitewater hosting department. The letter must be dated within the last two years, state the scholar s affiliation with the school, and affirm the visitor achieved at least intermediate skills. 3. Copy of scores or transcript containing a photo and birthdate from one of the following English language tests taken within the last five years and meeting the stated minimum scores below. No other testing scores or certificates form other centers or English language schools will be accepted. a. TOEFL i. ibt-65 total ii. Paper-550 total b. IELTS: 6 total 4. English proficiency interview assessment report from an interview conducted in English by the hosting faculty member. This can be done in person or by a videoconferencing method such as SKYPE. This host faculty member must be proficient in English. The interview will include three general questions and three additional questions focusing on the J-1 program content (research work, area of specialization, appointment directives). Please list your native language(s) Are you reporting a test score? If you are reporting a test score, please provide the following information: Test Name Date (MM/DD/YYYY) Score If you are *not* reporting a score, please write the name of the institution that will certify your English language proficiency. (Native English speakers may leave blank.)

4 ACADEMIC BACKGROUND Area(s) of academic specialization VISITING SCHOLARS PROGRAM APPLICATION Highest academic degree completed: Name of degree School granting degree Date degree earned (MM/YYYY) RESEARCH PROPOSAL Title of proposed research project: Brief summary of your research proposal:

5 FUNDING INFORMATION VISITING SCHOLARS PROGRAM APPLICATION The current requirement is $2,880 USD per month for the Visiting Scholar, and an additional $1,000 per month for an accompanying spous and an additional $500 per month for each accompanying dependent child. Attach letter(s) or official bank statement in English to substantiate each funding source. UW-Whitewater salary/stipend, if any U.S. Government Agency Name International Organization Organization Name Visitor s home Government Agency Name Visitor s Personal Funds Other Specify

6 Checklist of Documentation to be Submitted to the Center for Global Education The Center for Global Education (CGE) will not process an incomplete application; an incomplete application will result in processing delays. To avoid this, be sure to include: Visiting Scholar Application form fully completed and signed If not fully funded by UW-Whitewater, documentation of all funding sources: e.g. letter(s) from official sponsor or official bank statement (in USD and in English or with English translation on letterhead) Proof of English Proficiency A copy of the passport identity page for prospective Visiting Scholar and accompanying J-2 dependents Copy of Curriculum Vitae Research Proposal Special Notes: For visiting scholars already in the U.S. a visa transfer or change of status may be required. Please contact Erika Cuevas at cuevase@uww.edu if you think this may be needed.