International Arts & Artists

Application for All Program Categories

Personal Information
First and Last Name:
Gender:
Permanent Address (home address):

Specify full address with city, country, province, zip/postal code
Date of Birth: day: month: year:
City of Birth:
Country of Birth:
Country of Citizenship:
Passport Number:
If you don't have a passport number, please enter 000
Expiration Date: day: month: year:
Country in which passport was issued:
Marital Status:
Telephone Number (country code, city code, number):
Additional Telephone Number:
Fax:
Email Address:
   
Representative Information
Who is filling out this form?
If other, please state the relationship between The Trainee and the person who is filling this form:
Representative First and Last Name:
Representative Address:

Specify full address with city, country, province, zip/postal code
Representative
Phone Number:
Representative
Other Phone Number:
Representative
Fax:
Representative
E-Mail:
   
Immigration and Legal
Do you need a J1 Exchange Visitor Visa?

If not, why?
Have you ever been issued a J1 Exchange Visitor Visa before? If so, please state clearly
Name of Sponsoring Organization (ie Interexchange, CIEE)

If you answered Yes, please answer the following two questions:

Category of Visa (ie Student, Trainee, Work and Travel USA, Au Pair etc):





State the Start and End Dates of your previous Visa:

Start:

day: month: year:


End:

day: month: year:
Have you ever been refused entry to the United States?
   
Training Specifics
Please give a brief description of your objectives whilst undertaking your training:
Please name the U.S. city of your proposed program:
Please provide the names, titles, and e-mails of at least two professors or two employers who can confirm your education or work experience:
Desired length of training placement:

if other, please specify:
Desired start date of training placement: month: year:
Field of choice:
If you have an online portofolio, please provide the URL: http://
   
Resume
Please copy and paste the following parts of your resume
Education:
Please include institution, country, date of enrollment, and date of graduation.
Work History: Please include name of employer, country, position, date of start, and date of end of employment.
Skills
Languages
Awards/Recognition
   
 
Additional information:
   
How did you hear about us?

Select above and fill in the specific name.
Thank you, your feedback is greatly appreciated!!
 
Agreement

By Selecting "Yes" on the above option box, I certify that all information as provided by me on this Application Form is factually correct and up to date. I understand that any false or omitted information may lead to rejection of my J1 visa application. I undertake to provide updated information to International Arts & Artists when necessary.
Your application has not been sent if you don't see the confirmation page.