Request for DS-2019

Request for DS-2019

VLI & VLC 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.

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.
Name*
Enter your name as it appears on your passport.
Given Name Middle Surname
Gender*
- Female
- Male
Date of Birth*
MM
DD
YYYY
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*
Enter the address to which you would like your documents mailed.

Street Address Address Line 2 Country
Phone*
Email*
Enter your current e-mail address.
Mandatory Accident & Illness Insurance
The United States Department of State requires J-1 Exchange Visitors to have accident & illness insurance for the duration of their program dates. The estimated cost of insurance is based on your age. The cost is $542.70 for 9 months, if you are 24 years of age or younger. For persons between 25-49 years of age, the cost is $707.40 for 9 months. The cost of insurance will be covered by the Department of Modern Languages and Literature, as outlined in your contract. If you plan to remain in the U.S. after your program end date, it is highly advised you purchase insurance. CIE will remind you to do this as your program nears the end. Please be advised that insurance coverage after your official program end date will NOT be covered by UMW.
Personal Expenses
Although most of your expenses are covered per the terms of your contract, you will be responsible for personal expenses such as, airfare, university meal plan, medical expenses not covered by insurance, and personal travel expenses. As such, we require you to submit proof of finances in the amount of $500 US dollars minimum.
Meal Plan*
A meal plan for the University Center dining facilities is required. Prices below cover meal plans for the academic year (2 semesters). Please choose one.
- 225 Meal Plan $4,260
- 150 Meal Plan $4,086
- 85 Meal Plan $2,296
Personal Allowance*
- Academic Year $800
- One Semester $400
though most of your expenses are covered per the terms of your contract, you will be responsible for personal expenses such as, airfare, university meal plan, medical expenses not covered by insurance, and personal travel expenses. As such, we recommend a personal allowance in the following amounts.
Amount to Show in Proof of Finances*
This is the amount to be shown in your proof of finances.
Price: $0.00 Quantity:

VLI & VLC DS-2019 Request Form

Biographic Information

Mandatory Accident & Illness Insurance

Personal Expenses

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