Form Ds-2019 Request To Issue For A J-1 Exchange Visitor
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3Bryant University Office of International Affairs
Request to Issue Form DS-2019 for a J-1 Exchange Visitor – Step 3
Department: _____________________________________ Date: _______________________________
Contact Person: __________________________________ Email: _______________________ Phone: _______________
Purpose of this request (check all that apply):
New J-1
J-1 Extension
J-1 Transfer
New or Transfer?- If the scholar is currently in his/her home country, then submit a J-1 request indicating “New J-1.” If the scholar is already in the US in J-1 scholar status,
submit a J-1 request indicating “J-1 Transfer.” The components of the New and Transfer requests are essentially the same. However, the Transfer request requires
additional information. If the visitor is already in the US in a visa status other than J-1 scholar, indicate “New J-1” and attach documentation of the prospective scholar’s
current visa status. The Office of International Affairs can assist the scholar change his/her status to J-1 scholar.
Information about the Visiting Scholar
Visitor’s name___________________________________________________________________________________
(as it will appear in his/her passport)
family/last
first/given
middle
suffix
Date of birth _______________ Place of birth____________________,____________________ Male___Female____
mm/dd/yyyy
city
country
Country of citizenship______________________ Country of legal permanent residence_________________________
Position title in home country _____________________________________________ Number of years held_____________
Please check appropriate category for position in home country:
Professor
Researcher
Other __________________
Highest Degree Received: _____________ Date Degree Received:_____________ Field of Specialization: ______________
Visiting Scholar phone# :______________________________________ Email:_____________________________________
Will there be any offsite activity?
No Yes
If yes, please describe and provide the address:
_________________________________________________________________________________________________
Dates of intended visit (month/day/year):
From _____________ To_______________
Address where DS-2019 should be sent: ____________________________________________________________________
Street
City
Country
zip code
MEANS OF SUPPORT WHILE IN THE U.S. (IN U.S. DOLLARS):
The amount must be furnished even when it is not provided by Bryant University sources, since it is the sole basis for
determining whether or not the support will be adequate to maintain a minimum decent standard of living for the visitor
and his/her dependents. The funding information provided here will appear on a visa certificate and will be a
determining factor in whether a visa is actually issued by a U.S. Embassy or Consulate official. It is therefore important
this information be accurate. If the individual will be supported predominantly by personal funds, the Office of
International Affairs may require a bank statement or other documentation confirming the availability of these funds. All
amounts from all sources must be furnished in U.S. dollars.
Exchange Visitor’s government
Amount in U.S. $___________________
(Please attach an original letter outlining the funding, in English from the sponsoring government)
Other : Name of Organization/Institution(s): _______________________Amount in U.S. $___________________
_________________________________________Amount in U.S. $___________________
(Please attach an original letter outlining the funding, in English from the sponsoring organization(s))
Personal Funds
Amount in U.S. $______________
(Please attach an original bank statement, or certified copy, in English)
Direct Funding from, or administered by Bryant University
Amount in U.S. $___________________
Department:_________________________________________ Account Number____________________
Financial Support Guidelines:
A visitor must show minimum funding of $2,000 per month for him- or her-self, minimum funding of $500 per month for
each accompanying dependent child under age 21, and minimum finding of $500 per month for an accompanying spouse.
U. S. government regulations require that anyone in J-1 status and J-2 dependent status purchase adequate health
insurance as defined by the United States information Agency. Further details about health insurance will be provided to
the Exchange Visitors before their arrival in the U.S.
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