J-1 Exchange Visitor Request (For Scholar, Professor) Midwest University

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Instruction for J1 Visa Sponsorship Application of Visiting Scholar/Professor Form DS-2019 Certificate of Eligibility for Exchange Visitor Status All J1 exchange visitors must obtain a Form DS-2019, Certificate of Eligibility for Exchange Visitor Status in order to apply for a J1 visa to enter the U.S. or to transfer from another J1 sponsoring institution to Midwest University. The International Office of is responsible for issuing Form DS-2019 through the Student & Exchange Visitor Information System (SEVIS), the web-based computer system used by the U.S. Department of Homeland Security to track and monitor international students, scholars and programs. Please complete the application forms and attach required documents on the checklist before submitting to International Office for a Form DS-2019. Application Deadline: SIX WEEKS BEFORE ARRIVAL DATE of exchange visitor From receiving the Form DS-2019 at home country to schedule an interview with a U.S. Consulate to apply for a J1 visa, to make travel plans, and to finally arrive on campus, an exchange visitor needs a minimum of five weeks. International Office needs 3-5 business days to process the application, depending on the workload of the time the application is submitted. Visitors should NOT schedule visa interview with a U.S. Consulate until receiving confirmation that the DS-2019 has been mailed. Please plan early and submit completed application to International Office SIX weeks before the arrival date. Your cooperation is greatly appreciated by the visitors as well as by International Office staff.

1. The purpose of this request: New program scholar coming from abroad New program scholar transferring within the U.S. Extension scholar continuing on same program at MU 2. Personal Information: Gender: Male Female () E-mail Address: City of Birth : Country of Birth : Attach 2 recent 2x2 sized photos of yourself here Country of Citizenship Passport Number Passport Expiration Date() 3. Current Address: (all documents will be sent to this address) Postal Code City State(if necessary for mail) Country 4. Permanent Address Check here and do not complete if the information is the same 5. Emergency Contact (must be a relative, spouse, or guardian) Postal Code City State(if necessary for mail) Country Full name Relationship to You Postal Code City State(If necessary for mail) Country 6. Present or Former Position in the country of permanent residence: (For example: Is he/she a professor, researcher, graduate student, government employee/administrator, in the private sector? Please give concise description.) Has been a J-1 scholar in the US? Yes No End date of most recent J-1 program: Previous J-1 Sponsor organization name: Previous J-1 Sponsor contact information:

7. J-1 Program Dates: From: To: () () List the total of time, up to a maximum of five years (Professor or Research Scholar) or six months (Short-Term Scholar), for which the activities have been mutually agreed to and for which funding has been assured. 8. Title of Proposed Position: 9. Brief, Concise and non-technical Description of Activities of Exchange Visitor at MU: For example: Research in the field of veterinary pathobiology, research in mathematics, etc. 10. Source and amount of financial support: Please note that this must be documented in the form of an offer letter or, if the support is coming from the home institution or agency, documentary evidence must be attached to this application before we can prepare the scholar s documents. * $ Source: *(include department grant funding) Exchange visitor s government $ Source: Other organizations (please list) $ Source: Personal funds* $ *(Please attach proof of personal funds: bank statements, for example) 11. Accompanying Family Members: If the exchange visitor s spouse and/or children will accompany him/her to MU, we must also issue to the exchange visitor, a certification listing the names (as they appear in their passports) of the family members, their relationships to the exchange visitor and the dates and places of birth (city and country). Each dependent will be issued his/her own J document, DS 2019, as a J-2 dependent. Dependent #1

Dependent #2 Dependent #3 Dependent #4 Place of Birth: Note: If more space is needed, please attach an extra sheet of paper. Be sure that all names are spelled correctly and exactly as they are in the individual s passport. A misspelling of a name can lead to a visa denial. 12. Insurance Coverage (Medical, Evacuation, & Repatriation) Medical benefits of at least $100,000 per person per accident or illness Expense associated with medical evacuation in the amount of $50,000 Repatriation of remains in the amount of $25,000 A deductible not to exceed $500 per accident or illness Note: Participants in the J-1 Exchange Visitor Program are required to have medical insurance that covers them for sickness or accident during the period of time they are participating in MU s exchange visitor program. The Exchange visitor must provide proof of insurance as indicated above to the office of International Affairs within two weeks of the start of the program listed on the Exchange Visitor s DS-2019.

IMPORTANT: TWO-YEAR HOME COUNTRY PHYSICAL PRESENCE REQUIREMENT Some J-1 Exchange Visitors and their J2 dependents may be affected by a provision referred to as the "two-year home country physical presence requirement." This means that after completing his/her program in the U.S. as outlined on the Form DS-2019, an Exchange Visitor must return to his/her home country for two years. This requirement usually applies to the following: 1) Exchange Visitors whose programs are financed in whole or part, directly or indirectly, by the U.S. or home country government or a foreign sponsor; 2) Exchange Visitors whose country and field of specialized knowledge (skills) are listed in the most recent "skills list" published by the U.S. Department of State; 3) Exchange Visitors who are receiving graduate medical education or training in the U.S. A waiver of this requirement may be possible. This special characteristic of J-1/J-2 status should be clearly understood by the J1 Exchange Visitor. Any questions regarding this matter should be discussed with the International Office of. Attach ALL documents listed below and email to : 1. Copy of the bio-page of your and your dependents passports showing legal name, date of birth, city of birth, country of birth, gender and expiration date 2. If not funded by, proof of funding in English Other institutional support case: A letter from an employer or another institution on OFFICIAL business letterhead including a signature showing amount and length of support Private sponsors including parents (must include both of the following): - the sponsor's bank or other financial statements - letter(s) indicating the relationship between you and the sponsor(s), the amount of support and the length of support 3. Proof (in English) of health insurance coverage for full period of DS-2019 4. Your very brief research/teaching plan (less than half page) 5. Your CV/resume 6. Copies of previous DS-2019s for J1/J2 status issued by MU and/or any other U.S. institutions (if you were in J1 status previously) 7. Funding for dependents if coming: please provide original financial documents of $5,000/year for spouse plus $3,500 for each child) $ 8. Copy of marriage certificate in ENGLISH (must be an official legal translation) I attest that I have read the information above and fully understand its contents. Signature Date()