ECU J-1 Visiting Scholar DS-2019 Request Form PART A- To be completed by the Exchange Visitor Please complete the information below and return it to the personnel representative or faculty supervisor in the ECU department that will sponsor your visit. Along with the DS-2019 Request Form, please include the required supporting documents listed on page 2. Exchange Visitor s Biographical Information Family Name (Last Name): City of Birth: Country of Citizenship: Given Name (First Name): Country of Birth: Gender: Male Female Country of Legal Permanent Residence: Residential Address in Home Country: Street Address (including street and apartment numbers): City: State/Province: Postal Code: Country: Telephone Number: Email: Has the EV been anywhere in the US in J visa status during the past 24 months?* Yes No *If yes provide a list of all dates in the past 24 months that the visitor was in the U.S in J visa status. Education Experience What position does the visitor hold in their country of legal permanent resident? (e.g: professor, student, researcher) Position/ Activity: Institution: City and Country: Date awarded Bachelor s degree (mm/dd/yyyy): List additional degrees or other qualifications: Visitor s Specific Educational Field: 1
Program Information Program start date (mm/dd/yyyy): Program end date (mm/dd/yyyy): Program Subject/field (e.g Physics): The category of this visitor at ECU will be (definitions p. 5) Teaching Research Other, please explain: Description of Research or Teaching Activity: Financial documentation: The Exchange Visitor must have appropriate proof of financial support before the DS-2019 form is issues. The minimum funding requirements for the J-1 Exchange Visitor are listed below. J-1 EXCHANGE VISITOR + SPOUSE + CHILD + SPOUSE + CHILD EACH ADDITIONAL CHILD $1,500 per month $2,150 per month $1,850 per month $2,500 per month $350 per month $18,000 per year $25,800 per year $22,200 per year $30,000 per year $4,200 per year In addition to the standard estimates for living expenses and other costs for the individual, the Exchange Visitor will be expected to show additional funds for each dependent accompanying them to the U.S. Additional Funds Required for Dependent Coverage: If dependents arrive in the U.S initially, or at a later date, the must furnish personal financial documents to show proof of sufficient funding for dependents while in the U.S. If the Exchange Visitor must provide additional personal or family funding for dependent support, submit original bank documents or copies of bank statements showing the specific amount of funds available. BANK DOCUMENTS MUST BE IN ENGLISH. MUST BE SHOWN IN U.S. DOLLARS. Proof of Support Letter If financial support is from any source other than, attach a proof of support letter. The proof of support letter must be an official document, on letterhead from the funding source. Support letters should also show: The amount of financial support to be received The dates for which funding will be provided Signature of a person in the organization who is authorized to guarantee funding An official stamp of the University Whether or not stipend includes an amount for medical insurance Financial Support: (List each source and amount of funds (in U.S dollars) Exchange Visitor s Government: $ ECU Department: $ 2
Will any U.S government funding be involved? YES NO a. If yes, state the name of agency providing funds: b. Was this government funding received specifically designated for this Exchange Visitor? YES NO c. Was the funding received specifically designated for an Exchange Visitor program? YES NO FUNDING FROM: AGENCY NAME: AMOUNT RECEIVED: U.S Government Agency: $ International Organization: $ Personal Funds: $ Other organizations or $ universities: Explain Other Funding Amount: Dependent Information: Will the Exchange Visitor bring immediate family members when arriving in the U.S? YES NO Only a lawful spouse and dependent children under the age of 21, who are not U.S citizens or were not born in the U.S are eligible for J-2 dependent status. Parents, siblings, children over the age of 21, servants, common-law spouses or paramours, same-sex partners, and other friends or relatives are not eligible for J-2 dependent status. It is sometimes beneficial for a J-1 Exchange Visitor to arrive alone at first, get settled, set-up an apartment, and then invite family members to arrive later. Others prefer to bring immediate family members with them. If Yes, please provide the following information for each person, using information from the passport: 3
If dependents are already in the U.S, provide: Passport Number: Passport Expiration Date: Country of Issuance: This request is to: invite visitor from another country transfer from another J-1 program change the status of an alien already in the U.S to J-1 status If the exchange visitor is currently in the U.S, attach photocopies of the front and back of 1-94 card, picture page of passport, and visa page. Include a copy of the D-S 2019 form. IF THE IS CURRENTLY IN THE U.S: Present non-immigrant status is: Sponsor is: Present appointment: Date of entry to the U.S in the current status: Permission to stay in the U.S expires on: PART B TO BE COMPLETED BY SPONSORING ECU DEPARTMENT: Sponsoring department: The individual within the Exchange Visitor s department who will be responsible for the visitor is: Name: Campus Phone Number: Campus Address: The person authorizing this appointment is: Signature/Title: (Department Chair/Director) DATE: The person authorizing this appointment is: Signature/Title: (Dean) DATE: PLEASE RETURN THIS APPLICATION AT LEAST 2 MONTHS PRIOR TO THE S ARRIVAL DATE TO ALLOW SUFFICIENT TIME FOR PROCESSING. 4
DEFINITIONS OF J-1 CATEGORIES: Student: An individual who is studying in the United States pursuing a full course of study leading to, or culminating in the award of a U.S degree from a post-secondary educational institution; or who is engaged full-time in a prescribed course of study of up to 24 months duration conducted by a postsecondary accredited educational institution. Professor: (Maximum stay is 5 years) An individual primarily teaching, lecturing, observing, or consulting at a post-secondary accredited educational institution, museum, library, or similar type institution. A professor may also conduct research unless disallowed by the sponsor. Research Scholar: (Maximum stay is 5 years) An individual primarily conducting research, observing, or consulting in connection with a research project at research institutions, corporate research facilities, museums, libraries, post-secondary accredited educational institutions, or similar types of institutions. The research scholar may also teach or lecture, unless disallowed by the sponsor. Short- Term Scholar: (Maximum stay is 6 months) A professor, research scholar, or person with similar education or accomplishments coming to the United States on a short-term visit for the purpose of lecturing, observing, consulting, training or demonstrating special skills at research institutions, museums, libraries, post-secondary accredited educational institutions or similar type of institutions. Specialist: (Maximum stay is 1 year) An individual who is an expert in a field of specialized knowledge or skill coming to the United States observing, consulting, or demonstrating special skills. Exception: professors, research scholars, short-term scholars, and alien physicians in graduate medical education or training. PLEASE NOTE: Department sponsors are responsible for the effective administration of their exchange visitor programs. Responsibilities include screening the prospective exchange visitors to ensure that they are eligible for program participation, the program is suitable to the exchange visitor s background, needs, and experience; and the exchange visitor possesses sufficient proficiency in the English language to participate in his or her program. Sponsors shall monitor, through employees, officers, agents, or third parties, the exchange visitors participating in their programs. (Definitions based on the Electronic Code of Federal Regulations, Title 22: Foreign Relations, PART 62, PROGRAM, current as of July 9, 2012) 5