Request for DS-2019

DS-2019 Request Form

The DS-2019 Certificate of Eligibility for J-1 Exchange Visitor Status is the form you will use to apply for your visa. All DS-2019 Forms will be sent electronically to the email provided.

Biographic Information
This information is required to issue your DS-2019 Certificate of Eligibility for Exchange Visitor Status (J-1 Non-Immigrant). Please enter your information accurately. ALL DS-2019 Forms will be sent electronically to the email provided.
Name*
Enter your name as it appears on your passport.
First/Given Name Middle Last/Surname
Gender*
- Female
- Male
Date of Birth*
Month
Day
Year
Place of Birth*
City Country
Citizenship*
Select your country of citizenship.

Country
Country of Legal Residence*
Select your current country of legal residence.

Country
Home Country Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Enter your current email address.
Emergency Contact Information
Please enter the name and contact information for the person you would like us to contact in case of emergency.
Primary Emergency Contact Name*
Contact's Relationship to You*
Emergency Contact's Phone Number*
Emergency Contact's E-mail Address*
Proof of Finances*
Drop files here or

Max. file size: 5 MB.
As an exchange student, you will not be charged tuition as a visiting student. However, you will be responsible for personal expenses such as accommodations, airfare, medical insurance (required by J-1 visa holders, $6.77/day), university meal plan (225 block recommended), medical expenses not covered by insurance, books and supplies, and other personal expenses. As such, we require you to submit proof of finances in the amount of $10,000 (US dollars) minimum.
Scan of Passport*
Drop files here or

Max. file size: 5 MB.

DS-2019 Request Form

Biographic Information

Emergency Contact Information

Center for International Education