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J-1Scholarrequestform

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Office of International Students & Scholars
J-1 Scholar Request Form
oiss@stthomas.edu, Tel: 651-962-6650, Fax: 651-962-6655
To obtain the J-1 visa from their nearest U.S. embassy or consulate, the University of St. Thomas must first issue the visitor a
“Certificate of Eligibility for Exchange Visitor (J-1) Status,” commonly referred to as Form DS-2019. All J-1 visitors at St. Thomas
must meet in person with an Advisor in the Office of International Students & Scholars (OISS) within 10 days of their arrival in the
USA to complete the immigration check-in requirement for their J-1 visa.
Verification of Eligibility
1. Has the exchange visitor been in the U.S. in J-1 (any category) or J-2 status during the previous 12 months?
No Yes (if yes, please attach copies of previous DS-2019s)
2. Has the exchange visitor been in the U.S. as a J-1 Research Scholar or Professor or as a J-2 dependent of a J-1 Research
Scholar or Professor during the previous 24 months?
No Yes (If yes, please attach all copies of previous DS-2019s)
The Exchange Visitor will be:
Short-Term Scholar (Short-Term Scholar category has no minimum and a 6 month maximum duration of participation that can
not be extended, and is not subject to the 24 month bar.)
Professor *
Research Scholar *
*Professor and Research Scholar categories have a 3 week minimum and a 5 year maximum duration of participation and are subject
to a 24 month bar from participating in a J-1 Professor/Research Scholar program when stay has ended.
PART I: Biographical and Program information (Please enter the information as it appears in the visitor’s passport.)
Family name
First name
Male Female Date of Birth (mm/dd/yyyy)
City of Birth Country of Birth
Country of Citizenship Country of Legal Permanent Residence
Visitor’s Home Country Address
Visitor’s Home Country Telephone Number
Visitor’s Email Address
Last Position in Home Country:
Undergraduate Student ____________________________________
(Name of Overseas Institution)
Graduate Student _________________________________
(Name of Overseas Institution)
University Teaching Staff or Researcher _____________________________________________
Example: Music professor at the University of Zurich.
Other __________________________________________
(Title and Name of Employer)
Please list how you have confirmed sufficient English proficiency, as determined by an objective measurement
A recognized English test
Signed documentation from an academic institution or English language school
A documented interview conducted by St. Thomas in-person or by videoconferencing, or by telephone if neither
options are viable
Subject / Field description: ______________________________________________________
Detailed description of the purpose of the visit to the University of St. Thomas:
Duration of participation: Start date: _____________________ End date: ____________________
Note: Exchange visitors are allowed to enter the U.S. up to 30 days prior to the start of their program and must depart the U.S.
within 30 days of the completion of their program.
Site of Activity (where the research/program will be performed) – list address/building number:
PART II: Documentation of financial support
Federal regulations require International Student Services to obtain certification that the visitor has adequate financial resources to
meet all expenses related to the J-1 program. ISS requires a minimum of $1000USD per month for J-1 Scholar / Professor funding
(including housing, board, health insurance, miscellaneous, etc.). Identify below the sources of funding available to the visitor for
the entire period of his/her stay. Identify each source of funding and the amount of financial support provided. For funding sources,
including the University of St. Thomas, please provide evidence of support such as bank statements or letters of employment
/ understanding.
Funding Sources Funding Amount
Program Sponsor (University of St. Thomas): _________________________________
U.S. Government Agency: _________________________________
International Organization: _________________________________
Exchange Visitor's Government: _________________________________
Binational Commission of the
Exchange Visitor's Country: _________________________________
All other organizations providing support: _________________________________
Please list organization name and funding amount
Personal Funds: _________________________________
TOTAL FUNDING: _________________________________
PART III: Dependent information no dependents (skip this section)
To be completed only if the visitor intends to bring a spouse or child/ren to the United States. If no dependents will be coming to the
United States, leave blank and skip to Part IV.
Name (Family, First, Middle)
Date of birth
(mm/dd/yy)
City & Country of
Birth
Relationship to J-
1 Scholar
Country of Citizenship
The J-1 Scholar must provide financial verification to OISS for his/her J-2 dependents in order for DS-2019 documents to be
issued on their behalf. This financial verification must be less than 6 months old and demonstrate funding available for $6000
USD or more per year for a J-2 spouse and $3000 USD or more per year for each J-2 child.
Dependents will: (check one) travel with the visitor travel separately
Departmental Agreement
• Host department agrees to notify OISS if there is any delay of the Exchange Visitor’s (EV) arrival.
• Host department agrees to notify OISS when the EV departs St. Thomas or if the EV is no longer participating in the
program activities described above.
• Host department understands that the EV must maintain health insurance as outlined in CFR 62.14.
• Host department agrees to notify OISS of any change in an EV’s program during their time at St. Thomas.
• The host department understands the importance of including a cultural component in the Exchange Visitor’s program at
St. Thomas as required by 22 CFR 62.8(d) Furthermore, the department agrees to include at least one cross-cultural
opportunity during the Exchange Visitor’s stay.
• Host department agrees to notify OISS if the EV will be outside the U.S. for more than 60 days.
• Host department confirms that the EV has sufficient English ability to effectively participate in his/her Exchange Visitor
Program activities.
The request for Exchange Visitors must have the approval of the Department Chair. The faculty member initiating this request
understand the rules associated with exchange visitors.
PART IV: Signatures/Approvals
The St. Thomas Faculty / Staff member completing this form (listed below) agrees to the responsibilities listed above and is
responsible for ensuring that the J-1 Exchange visitor will follow through with their OISS check-in within 10 days of their arrival.
Name/Title of St. Thomas Faculty/Staff member completing this request form:
Email: Phone Number:
Name of Department Chair:
Signature of Department Chair approving of this scholar’s visit:
Please attach the following to the request form.
1. Verification of funding
2. CV or Résumé.
3. Copy of passport for the EV and all dependents.
Note: OISS will ensure that Visiting Scholars can obtain ID cards on campus. The host department is responsible for
securing office space, St. Thomas email and other such requests for the scholar to perform their research/teaching at St.
Thomas.
Please complete this request form and return it to OISS along with copies of financial documents:
Office of International Students & Scholars (OISS)
University of St. Thomas 2115 Summit Ave. Mail #5014, St. Paul, Minnesota 55105
Tel: 651-962-6650, Fax: 651-962-6655
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Completed 18 November 2019

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