ILLINOIS INSTITUTE OF TECHNOLOGY J-1 SCHOLAR REQUEST FORM (TO BE COMPLETED BY THE DEPARTMENT)

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1 J-1 SCHOLAR REQUEST FORM (TO BE COMPLETED BY THE DEPARTMENT) Please cmplete this frm and return it, alng with the individual s sectin, t the Internatinal Center as sn as pssible s that we may issue the DS-2019, which is used t apply fr a J-1 entry visa at a U.S. Cnsulate abrad. Due t delays in visa prcessing verseas, please submit the frm and all required dcumentatin at least three mnths in advance f the J-1 schlar s anticipated start date at IIT. Please nte that in sme instances visa prcessing may take lnger. Please read the fllwing infrmatin befre yu cmplete the request frm: Length f Stay: Prfessrs and research schlars are permitted t remain in the United States fr a ttal f five years maximum. Shrt-term schlars are permitted t remain in the United States fr up t six mnths; n extensin is permitted. Repeat Participatin in the Research Schlar and Prfessr Categries: After a schlar spends time in the U.S. in ne f these categries, he/she is prhibited frm returning t the U.S. fr 24 mnths in either the prfessr r research schlar categry. There are n exceptins t this rule. 12-Mnth Rule: An individual will nt be eligible fr J-1 research schlar r prfessr status if he/she was in the U.S. in any J status fr six ut f the previus 12 mnths. In such cases, he/she must be ut f J status fr ne year befre being eligible fr J-1 research schlar r prfessr status. English Language Requirement: New federal regulatins beginning January 5, 2015 require use f an bjective measurement f English language prficiency t determine the language prficiency f all J-1 schlars. Prf f ne f these measurements must be submitted with this frm: Results frm a recgnized English language test that meet r exceed the scre belw (preferred methd) Accepted English language tests and minimum requirements: TOEFL IBT 57 TOEFL CBT 163 TOEFL PBT 487 IELTS 5.5 PTE 42 Phtcpies f results mailed directly t the student r screen shts f the nline scre reprt are acceptable. Signed dcumentatin frm an academic institutin r English language schl verifying yu have at least intermediate-level English language skills Or dcumentatin f an interview cnducted by the hst department either in persn, by videcnference, r by telephne if neither f the first tw ptins are viable ptins Cntact the Internatinal Center fr interview instructins shuld yu wish t use this methd. NOTE: The Internatinal Center reserves the right t ask fr further verificatin. Tw-Year Hme Residency Requirement: Sme J-1 schlars and their dependents are required t return t their cuntry f permanent residence fr a minimum f tw years upn cmpletin f the J-1 prgram befre they will be eligible fr H, L, K, r permanent residency status. On rare ccasins the visitr may file fr a waiver f this requirement. Withut the waiver, the J-1 exchange visitr may nt change nn-immigrant status while in the U.S. r apply fr any f the fur statuses listed abve. Once a waiver is received, extensins f J status are nt permitted. Health Insurance: J-1 participants and their accmpanying dependents are required by law t carry health insurance fr the duratin f the prgram. They shuld btain this prir t cming t the U.S. but nt necessarily befre cmpleting this request r applying fr the entry visa.

2 Funding: Prf f funding t meet the fllwing expenses fr the duratin f the schlar s stay in the U.S.: Living expenses f $1,400/mnth ($16,800/year) IIT student health insurance fee ( if applicable Cst f tw research credits per term (ne credit/summer term), if required t register Living expenses fr any dependents (see Dependents sectin belw) Evidence f funding must be less than six mnths ld and may be ne r mre f the fllwing: Cpy f the invitatin letter listing the financial supprt, if funded by IIT Bank statement in the schlar s name Schlarship/grant award letter in the schlar s name indicating the amunt and duratin f supprt Letter frm the schlar s emplyer r academic institutin indicating the amunt and duratin f supprt Bank statements in a spnsr s name, plus a letter f supprt frm the persn named n the statement, indicating the amunt and duratin f supprt Please nte in cases where a funding range (instead f a specific amunt) is given, nly the lwest amunt in the range can be used when calculating funding ttals. Dependents: J-1 participants may apply t bring their spuse and children (unmarried and under the age f 21) as J-2 dependents. The schlar must shw an additinal $375/mnth ($4,500/year) fr the first dependent and $250/mnth ($3,000/year) per each additinal dependent they wish t bring t the U.S. Please make sure that the financial dcuments are prvided accrdingly. Please nte that gvernment regulatins require that all J-1s and J-2s prvide a valid address. If the dependents d nt have valid addresses, the schlar must list his/her wn. It may nt be left blank.

3 J-1 SCHOLAR REQUEST FORM DEPARTMENTAL CHECKLIST Please turn in the fllwing t the Internatinal Center, MTCC 202, t request a DS-2019: J-1 schlar request frm cmpleted by department Cpy f the invitatin letter signed by department head r cllege dean. Please nte that yu shuld send the riginal t the J-1 schlar. J-1 schlar request frm cmpleted by schlar Prf f English language prficiency Financial dcumentatin. Dcuments must be in English and less than six mnths ld. If funding is frm IIT, this shuld be included in the appintment letter, and a cpy is sufficient. Cpy f the schlar s passprt bigraphical page (plus that f any dependents) Health Insurance Attestatin Frm signed by the schlar Once the cmplete request is submitted t the Internatinal Center, it may take us up t tw weeks t prepare the DS After we have prepared the DS-2019, we will infrm yu by s yu may either pick it up r receive it by campus mail. It is then the department s respnsibility t mail the DS-2019 packet t the schlar in his/her hme cuntry.

4 J-1 REQUEST FORM (TO BE COMPLETED BY THE DEPARTMENT) Please cmplete the infrmatin belw. ALL fields are required. Schlar s family name (as it appears in passprt): Schlar s first name (as it appears in passprt): Schlar s middle name, if applicable: What will be the schlar s primary activity? Research Teaching Requested dates f activity: t (mm/dd/yyyy) Requested J-1 categry: Shrt-Term Schlar will nt need t stay fr mre than six mnths Research Schlar r Prfessr may need t stay fr mre than six mnths Will schlar be required t enrll in research credits? N Yes (Make sure this is apprpriately dcumented in the invitatin letter.) Field f research/teaching: (i.e.. mechanical engineering, rganic chemistry, cmparative law, etc.) Describe the prpsed activities (may use technical terms): Full street address where schlar will be researching/teaching: Address: City, State ZIP: Methd fr determining the schlar s English language prficiency: (please attach dcumentatin) Results frm a recgnized English language test Signed dcumentatin frm an academic institutin r English language schl Dcumented interview cnducted by the department

5 List all funding surces fr the duratin f the schlar s prgram: Must cver cst f registratin each term if required t enrll in research credits Must include at least $1,400 per mnth fr the duratin f the DS-2019 Must include dependent living expenses, if applicable (see instructins) Include dcumentatin f all funding surces IIT Funds Please nte that grant mney received frm gvernment agencies and used t cver a variety f research and payrll expenses is cnsidered IIT funding fr the purpse f issuing this frm. U.S. Gvernment Agency Name f agency Applicable nly if the grant mney is designed slely t fund the exchange visitr. Hme Cuntry Gvernment In cases where a funding range (instead f a specific amunt) is given, nly the lwest amunt in the range can be used when calculating funding ttals. Other Organizatin Name f rganizatin Persnal/Family Funds DEPARTMENT INFORMATION Department Name Departmental Cntact Phne Inviting/Supervising Faculty Member Signature Date Supervising Faculty s Address Supervising Faculty s Department Head Signature Date