Fillable Info Sheet For Exchange Visitor-1

Fill Online, Printable, Fillable, Blank Info Sheet For Exchange Visitor-1 Form

Use Fill to complete blank online CALIFORNIA STATE UNIVERSITY, FRESNO pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Info Sheet For Exchange Visitor-1

On average this form takes 30 minutes to complete

The Info Sheet For Exchange Visitor-1 form is 2 pages long and contains:

  • 0 signatures
  • 27 check-boxes
  • 107 other fields

Country of origin: US
File type: PDF

U.S.A. forms for California State University, Fresno

BROWSE CALIFORNIA STATE UNIVERSITY, FRESNO FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Information Sheet
Exchange Visitor Permit (J-1 Visa)
Family
Name
Given
Name
Middle
Name
Date of Birth
(Month/Day/Year)
Male Female
Country
of Birth
City
of Birth
Citizen of: Legal permanent
resident of:
Position in that country
prior to coming to US:
CSU Fresno sponsoring Department:
(Include Mailing Address)
Have you previously
held a J-1 visa?
yes no
If yes Dates: __/___/______ to __ / ____/______
If yes, School where
The visa was issued:
CSUF Arrival Date
(Month/Date/Year):
CSUF Departure Date
(Month/Date/Year):
Person hosting exchange visitor must provide
cultural orientation to the US, transportation,
arrange housing, etc.
Name: ________________________ ext: ______
Rate English language Competence:
10 - - - - - - - - - - - - - 5 - - - - - - - - - - - - -1
Excellent Good Poor
Basis for assessment:
Health insurance
provided by:
On Campus Other
If other health insurance
Please indicate policy name:
This Visitor is:
Student. Will enroll in: regular courses or extension courses, units: ______
Professor. Meets requirements as a faculty member that the institution would hire, primarily involved in
teaching
or lecturing.
Research Scholar. Meets requirements as a faculty member that the institution would hire, involved
primarily in conducting research
.
Specialist. Expert in a field of specialized knowledge or skill to engage in observation, consultation or
demonstration of special skill, limited to less than one year, may be non-academic.
Short-term Scholar. Professor, research scholar or specialist or a person with similar education or
accomplishments coming to the U.S. for a short-term visit – a few days to less than four months.
Specific field of the
Exchange visitor:
Describe the expected activities
for the exchange visitor: _____________________________________________________________________
__________________________________________________________________________________________
Privileges provided to the exchange visitor: (check all that apply)
Library
Adjunct faculty status
Computer use
Email account
Office
Telephone
Parking
Up front monies
Approval to work, receive payment
Audit or sit-in on classes
Other, please detail:
__________
___________________________
PS ID: ________________________
Information Sheet
Exchange Visitor Permit (J-1 Visa)
Page 2 of 2
Financial Support:
California State University, Fresno. $ ______________________
Students: Provide tuition waiver, scholarship or assistance verification
U.S. government agency. Agency: _________________ $ ______________________
International Organization. Name: __________________ $ ______________________
Exchange visitor’s government (attach proof and amount of support) $ ______________________
Bi-national Commission. List: ______________________ $ ______________________
Other organizations. List: __________________________ $ ______________________
Personal Funds $ ______________________
Family members accompanying the exchange visitor:
Spouse
Family
Name
Given
Name
Relationship:
Male Female
Date of Birth
(Month/Date/Year):
Country
Of Birth
City of birth
Dependent
Family
Name
Given
Name
Relationship:
Male Female
Date of Birth
(Month/Date/Year):
Country
Of Birth
City of birth
Dependent
Family
Name
Given
Name
Relationship:
Male Female
Date of Birth
(Month/Date/Year):
Country
Of Birth
City of birth
Dependent
Family
Name
Given
Name
Relationship:
Male Female
Date of Birth
(Month/Date/Year):
Country
Of Birth
City of birth
Approvals:
Mentor /Host
Print Name: Department:
Signature: Date: Email:
Department Chair:
Print Name: Department:
Signature: Date: Email:
Dean:
Print Name: Department:
Signature: Date: Email:
Academic
Personnel
Print Name: Department:
Signature: Date: Email:
Study Abroad &
International Exchanges:
Print Name: Department:
Signature: Date: Email:
Responsible
Officer:
Print Name: Department:
Signature: Date: Email:
Please Forward form for next signature, final approval and record keeping of this form will be:
International Student Services and Programs.
Joyal Administration, Room 256, MS JA56
Last edit: 2-1-10
Citizen of:
Legal permanent
resident of:
Citizen of:
Legal permanent
resident of:
Citizen of:
Legal permanent
resident of:
Citizen of:
Legal permanent
resident of:
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Info Sheet For Exchange Visitor-1

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 13 May 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document