DS-2019 Request Form

Transcription

1 DS-2019 Request Frm Name f Department and faculty r staff member cmpleting frm The primary purpse f J-1 schlars prgrams is fr academic exchange, therefre J-1 visas are nt apprpriate fr tenure-track psitins. Hwever, it is imprtant t nte that a J-1 schlar may hld a psitin nrmally classified as tenure-track, s lng as the psitin will be temprary fr the J-1 schlar. 1. Department Respnsibilities: Departments are expected t prvide wrkspace, library, cmputer access, an ID card, and a dcumentable crss-cultural interactin between the J-1 schlar and the department, the campus, and the cmmunity. The DS-2019 issuance prcessing relies n departments t refer any cncerns abut visa status, rientatin t the campus and cmmunity, insurance r ther matters t us. Departments are als required t: (please read and initial by each item) Ntify iss@uccs.edu if the J-1 Schlar will nt arrive within 30 days f the begin date Send the schlar s full travel itinerary f travel and a cpy f the visa t iss@uccs.edu Ntify iss@uccs.edu when the J-1 Schlar cmpletes his/her prgram Reprt any change r additin f the purpse f visit and descriptin f duties NOT send the DS-2019 t the visitr electrnically Prvide ISS@uccs.edu with the visitr s J-1 visa and travel itinerary immediately when available IF THE J-1 PARTICIPANT IS CHANGING ENTRY DATES FOR ANY REASON PLEASE NOTIFY iss@uccs.edu IMMEDIATELY SO THAT ALL DOCUMENTS CAN BE UPDATED. Failure t d s can result in the J1 participant unable t enter the cuntry. Signature f preparer: 2. Categries: This frm is used fr J-1 Schlars wh are classified as a Research Schlar, Shrtterm Schlars, Prfessrs, r Specialists. The J-1 prgram is fr temprary visits t the U.S. fr the purpse f teaching, instructing r lecturing, bserving, cnducting research, cnsulting, r demnstrating special skills. Maximum Length f Stay: Research Schlar 5 years Shrt-term Schlar 6 mnths Prfessrs Specialist 1 year Interns Mnth Bar: Anyne wh has been in the U.S. in any J categry fr mre than 6 mnths is barred frm re-entering the U.S. as a J-1 Research Schlar r Prfessr fr 12 mnths fllwing the cmpletin f his/her prgram r stay. This regulatin des nt apply t Shrt-term Schlars Mnth Bar: Anyne wh has been in the U.S. as a J-1 Research Schlar fr 24 mnths fllwing the cmpletin f his/her prgram r stay. This nly applies t thse wh cmpleted prgrams after 11/17/ Academic Credentials: The department must ensure that the J1 Schlar has the apprpriate academic credential t perfrm the prpsed activity. 6. English Prficiency: Federal Regulatins require all exchange visitrs t pssess sufficient prficiency in the English language, as determined by an bjective measurement f English

2 language prficiency, successfully t participate in his r her prgram and t functin n a day-tday basis. The hst department must verify the visitr's English language prficiency thrugh a recgnized English language test, by signed dcumentatin frm an academic institutin r English language schl, r thrugh a dcumented interview cnducted by the department either in-persn r by videcnferencing, r by telephne if videcnferencing is nt a viable ptin. Please keep in mind that a cnsular fficial may deny a freign natinal a J-1 visa if they deem their English language skills t be inadequate. (22 CFR (a)(2)) 7. Lead Time: Please submit part A part B, and all attachments at least 90 days befre the intended start date f the prgram. This allws time fr Certificate f Eligibility and ther prcesses t be cmpleted and the DS-2019 t be issued and frwarded t the prper departments, prspective schlar wh must then apply fr an entry visa at the U.S. Cnsulate. 8. Evidence f Financial Supprt: If the J1 Schlar s supprt is frm a surce ther than UCCS, evidence f funding must be included with this request. If supprted by gvernment r internatinal funds, an fficial statement translated int English with funds must be prvided. If yu are prviding yur wn supprt an example letter f supprt is in this frm t include with a current bank statement translated int English must be prvided that is recent within 3 mnths. Sufficient financial supprt is required fr a J-1 Schlar. J-2 dependents wh accmpany the J-1 Schlar require additinal funding. Prf f funding must be prvided befre any DS-2019 dcuments will be issued. Financial dcuments must shw prf f supprt fr the entire length f stay. 9. Begin a New Prgram: T begin a new J-1 prgram usually means the J-1 Schlar will cme frm his/her hme cuntry f citizenship r residence directly int the U.S. 10. Transfer: T transfer t UCCS means the Schlar is already in the U.S. at anther institutin and is invited t transfer t a prgram at UCCS within the same categry and field. Cpies f all Frms DS-2019 issued by ther institutin(s) must be attached t this frm. Please submit a transfer request with a lead time f six weeks t prvide time fr UCCS t btain an fficial release frm the current institutin. 11. Insurance Requirement: Health and accident insurance cverage is Federally mandated fr all J-1 Schlars and their dependents while they are in the U.S. The J-1 Schlar Insurance Attestatin must be cmpleted prir t issuing the DS Detailed insurance requirements are listed belw. 12. C.V./Resume: An up-t-date CV r resume must be attached t the J-1 Request Frm. 13. Passprt: Attached a legible cpy f the ID page(s) f the passprt fr the J-1 Schlar and any dependents accmpanying t the U.S. if applicable. 14. Part B: (Schlar Prfile) shuld be cmpleted and signed by the J-1 Schlar, if riginal is nt immediately pssible a fax r scanned cpy is acceptable. If the infrmatin is btained by , a departmental designee shuld sign t verify its accuracy. Please btain all the infrmatin and cmpile all the attachments befre submissin. Please the cmpleted J-1 Schlar request frm (Parts A and B) and all the required attachments t: iss@uccs.edu.

3 Checklist t be submitted by department and J1 schlar: Prf f financial supprt (schlar r department) Insurance attestatin (schlar) Cpy f passprt (schlar) English prficiency attestatin (department) C.V. r resume (schlar) Invitatin letter (department) DS-2019 Request Frm Part A T be cmpleted by spnsring department Department Inviting J-1 Schlar: J-1 Schlar s Surname: First name: Middle name: This request cvers perid frm exact dates: t (mm/dd/yyyy) (mm/dd/yyyy) Please check: Begin a New Prgram Extend current status Transfer t UCCS Please Check: Research Schlar Shrt-term Schlar Prfessr Specialist Interns Site f academic Activity: Name f Department/institute Address r department building Please describe briefly the activity t be perfrmed by the J-1 Schlar during his/her prgram. Identify the specific research area r area f instructin and/r study. During the perid cvered by the request, financial supprt will be prvided t the J-1 Schlar by (check all that apply) A: University f Clrad, Clrad Springs $ UCCS has has nt received funding fr internatinal exchange frm ne r mre U.S. gvernment agencies t supprt this J-1 Schlar. This des nt apply t federal grants awarded t UCCS, unless the grant is specifically fr internatinal exchange. (ex: Fulbright Exchange)

4 Financial supprt frm rganizatins ther than UCCS will be prvided by (check all that apply): B: U.S. Gvernment Agency: $ C: Internatinal Organizatin: $ D: The J-1 Schlar s Gvernment $ E: The Bi-natinal Cmmissin in the Schlar s Cuntry $ F: Other Organizatin Prviding Supprt: $ G: Persnal Funds $ Name f Faculty/Staff Spnsr Faculty/Staff Spnsr Signature Date Faculty Faculty Phne # Name f Department Chair Department Chair Signature Date Department Cntact s Name Department Cntact Phne # Please indicate where yu wuld like the DS-2019 sent nce it is issued: Campus mail t the department Attn: Ntify department t pick up

5 DS-2019 Request Frm Part B T be cmpleted by schlar Department inviting J-1 Schlar: Surname frm passprt First Name frm passprt Middle name n Passprt (if any) Gender: Marital Status: Date f birth (mm/dd/yyyy) City f birth Cuntry f birth Cuntry f citizenship Cuntry f legal residence Highest degree earned Field f study/specialty Title f psitin in hme cuntry (if any) Name f emplyer/institutin _ Type f emplyer/institutin (university, private cmpany, lcal gv) List all previus perids f J status (attach separate sheet if necessary) and include all cpies f DS-2019: J-1 Prgram Spnsr Start date End date J Categry Dependent Infrmatin: If dependents (spuse and unmarried children under age 21) will cme t the U.S. in J-2 status, please prvide evidence f sufficient financial supprt and insurance cverage. Bigraphical infrmatin must match passprt exactly: Spuse Child 1 Child 2 Child 3 Gender (Female r Male): F M F M F M F M First name: Last name Middle name: Date f birth: City f birth: Cuntry f birth: Cuntry f citizenship: Cuntry f legal residence: If the dependents will be arriving separately, please indicate the exact date they will arrive: UCCS strngly advises J-1 exchange visitrs t purchase insurance prir t their visa interview in the event prf f insurance is asked fr during the review.

6 I certify that the infrmatin prvided is true and accurate t the best f my knwledge: Signature f J-1 Schlar Date Mailing address: Hme address: (Freign)

7 Example f Invitatin letter t participate in J-1 Prgram (must be n letterhead) Dear Dr., Mr., Mrs.,, I am pleased t ffer yu a psitin/invitatin as a (research schlar/pst-dctral/ prfessr/shrt-term schlar) (department/prgram) with an effective date f and cntinuing thrugh (end date). This ffer/acceptance is subject t yur satisfying all the requirements f the J-1 Visa Prgram spnsred by the University f Clrad, Clrad Springs, as well as applicable t federal regulatins. This ffer is als extended with the understanding that yu have adequate cmmand f the English language t participate in the J-1 prgram. 2. Purpse and Limitatin f the J-1 Exchange Visitr Prgram The brad purpse f the Exchange Visitr Prgram is t prmte internatinal educatinal and cultural exchange, in rder t develp mutual understanding between the peple f the Unites States and ther cuntries. Exchange prgrams exist in a variety f frmats and permit visitrs t cme t this cuntry fr a wide range f activities. This schl s Exchange Visitr Prgram prvides pprtunities fr study and research. Many participants in the J-1 prgram are subject t a requirement that they return hme fr a minimum f tw years upn cmpletin f their prgram. The purpse f the requirement is t have the hme cuntry benefit frm the Exchange Visitr s experience in the United States. Exchange visitrs cme t this cuntry fr a specific bjective such as a prgram f study r research prject. The requirement is intended t prevent a participant wh is subject frm staying lnger than necessary fr the bjective, and t ensure that he/she will spend at least tw years in the hme cuntry befre cming back t the United States fr a lng-term stay. The terms f this requirement are specified n the black and white cpy f the DS-2019 frm. If yu have any questins abut the requirements, please raise them with the Cnsular Office when yu apply fr yur visa. 3. Descriptin f Duties During yur stay yur duties and respnsibilities are as fllws:. Yur nrmal hurs f wrk r study are at the lcatin f (Please insert a blck statement here regarding the general verview f yur specific prgram) SAMPLE 4. Financial Statement f Supprt Dcumentatin must be submitted by the J-1 participant regarding finances and insurance cverage r a letter f acceptance r emplyment ffer frm the department. Select ne belw- alternate sentences f financial supprt. The department f will prvide a salary supprt fr yu in the amunt f $ (mnthly/annually). Yur hme gvernment/institutin will prvide financial supprt in the amunt f $

8 (mnthly/annually). Yu must prvide apprpriate written dcumentatin f this supprt signed by the apprpriate fficial when yu return this letter. Yu will prvide yur wn funding fr this exchange experience in the amunt f $ (mnthly/annually). Yu must prvide written dcumentatin (i.e. bank statement) that yu have adequate funds. Freign statements must be translated int English. 5. Insurance Cverage. Failure t Maintain Insurance Cverage Will Result in immediate Terminatin f yur DS Federal regulatins REQUIRE that all J-1 participants and their dependents have adequate medical/life insurance cverage that prvides: $100,000 f cverage per accident r illness that may include a deductible f up t $500. $25,000 fr repatriatin f remains and $50,000 fr emergency evacuatin back t yur cuntry. Select ne- alternate sentences n insurance (T be cmpleted by J1 participant): Effective (date) yu will need t enrll in the University (r ther agency) health and life insurance prgram. The cst t yu f the university prgram ranges. Please refer t the student health center page n fr prices and plicy details. In additin t health and life insurance cverage thrugh the university yu will need t purchase frm private carrier cverage fr repatriatin f remains and emergency evacuatin. Please prvide written dcumentatin dcument f such cverage when yu return this letter. (if this statement is used the spnsr must cmplete the blanks.) Yu will be required t purchase insurance frm a private carrier befre yu arrive in the U.S. The cst will vary between $40-$300 per mnth, depending n whether individual r family cverage is required. Please prvide fficial dcumentatin f such cverage when yu return this letter. It is ur understanding that yur hme institutin/gvernment will prvide insurance cverage that meets the abve requirements. Please prvide written dcumentatin f such cverage when yu return this letter. SAMPLE

9 Statement f Cmpliance with Exchange Visitr Health Insurance Requirements J Exchange Visitrs and their dependents must be cvered by sickness and accident insurance fr the duratin f their stay in the United States. Failure t purchase such insurance may lead t lss f legal immigratin status and terminatin frm the Exchange Visitr Prgram. These United States Department f State (DOS) regulatins are published in the Cde f Federal Regulatins [22 CFR 62.14]. Minimum health insurance cverage must prvide: Medical benefits f at least $100,000 per accident r illness Repatriatin f remains in the amunt f $25,000 Expenses assciated with the medical evacuatin f the exchange visitr t his r her hme cuntry in the amunt f $50,000 A deductible nt t exceed $500 per accident r illness. The regulatins cntinue: An Exchange Visitr wh willfully fails t maintain the insurance cverage set frth abve... r wh makes a material misrepresentatin t the spnsr [University f Clrad Clrad Springs] cncerning such cverage shall be deemed t be in vilatin f these regulatins and shall be subject t terminatin as a participant. [22 CFR 62.14(h)] J-1 Exchange Visitrs must sign and return the fllwing statement befre arrival r upn arrival at UCCS: I understand the insurance regulatins as stipulated by the DOS, and I certify that I will have acquired the required insurance prir t my arrival and I will enrll in an insurance plan r cmbinatin f plans t meet the specificatins immediately upn my arrival. I further certify that I will als enrll all dependents wh currently accmpany me r wh fllw t jin me in J-2 visa status. I als understand that if I willfully fail t purchase apprpriate insurance cverage, the University is bligated t terminate me frm its Exchange Visitr Prgram and will ntify the DOS that I have been s terminated. Such actin will result in my lss f legal immigratin status. Name printed: Signature: Date:

10 Schlar Checklist Visa T apply fr a J1 visa at a U.S. cnsulate, yu will need t present the fllwing items t the fficial: Passprt that is valid fr travel fr at least 6 mnths beynd the applicant s intended perid f stay in the U.S. Frm DS-2019 frm UCCS- Must be riginal Letter f invitatin Prf f financial supprt Prf f prficiency in the English language Frm DS-160 nnimmigrant visa applicatin This frm is available withut charge at all cnsular ffice and must be cmpleted nline: Suitable clred phts sized such that the head is between 1 inch and 1 3/8 inches (22 mm and 35 mm) r 50% and 69% f the image's ttal height frm the bttm f the chin t the tp f the head fr mre infrmatin, please visit: Visa applicatin prcessing fee Additinal items fr J2 dependents if any: All f the abve listed as well as: Prf f familial relatinship (marriage certificate, birth certificate(s) translated int English) Frm DS-2019 fr each dependent Pre-Travel Send a cpy f the cmpleted travel itinerary t the UCCS hsting department Send a cpy f yur apprved visa t the UCCS hsting department Travel Clrad Springs Natinal Airprt (COS) Planning is the key! Think several weeks in advance abut what yu will need fr yur trip and assemble it. Make several cpies f ALL f yur imprtant dcuments. These include all f the dcuments that yu ve been issued and the pages in yur passprt shwing yur bigraphy infrmatin. Keep ne set f cpies in yur carry-n luggage, ne set in yur checked baggage and leave a set at hme with smene wh can send them t yu quickly if needed. If yu travel utside f the U.S. during yur prgram: Make sure yur visa r passprt is nt ging t expire. If it has r will expire while yu are utside f the cuntry yu will need t apply at the cnsulate t have it renewed befre re-entry in the U.S.

11 If yu have changed yur visa type since yur entry int the U.S. yu will have t apply fr an updated visa at the cnsulate befre re-entry. WARNING: It can take several weeks t apply fr a visa. Make an appintment with the U.S. Embassy/Cnsulate in the cuntry yu are traveling t BEFORE yu leave the U.S. It may take 3-4 weeks just t get an appintment. If yu are traveling utside f the U.S. t a cuntry OTHER than yur hme cuntry, call the embassy f that cuntry t learn if yu need a visa t enter that cuntry. If s ask fr the requirements, cst, and time frame t apply fr that visa. Keep in mind the abve mentined time frames. Traveling within the U.S. it is nt required t apply fr a new passprt r visa but it is a gd idea t carry cpies f yur frms with yu. **D NOT travel with a pending USCIS applicatin. Yu risk having the applicatin cancelled. Orientatin a) Upn yur arrival in the United States yu shuld cntact yur faculty spnsr wh will prvide yu with a general rientatin and accesses t the Clrad Springs area and yur specific prgram. (This infrmatin must be cmpleted by the spnsring department). b) Once yu have made yur initial cntact with yur faculty spnsr yu must cntact the Internatinal Schlar Specialist lcated in the Main Hall Rm 108 fr SEVIS check in and SEVIS rientatin with yur passprt, visa, I-94, and DS This is mandatry and yur DS-2019 can and will be cancelled if this is nt dne within 30 days f yur prgram start date.