F O R E I G N N A T I O N A L I N F O R M A T I O N F O R M ( P A G E 2 )
The Foreign National Information Form must be completed before you can receive any form of payment. Please list any visa
immigration activity in last three calendar years and all F, J, M or Q Visas since 1/1/85:
Date of Entry
Date of Exit
(A) Visa Immigration Status
(B) J-1 Subtype
(C) Primary Purpose
Have You Taken Any
Treaty Benefits
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Yes
No
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Yes
No
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Yes
No
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Yes
No
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Yes
No
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Yes
No
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Yes
No
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Yes
No
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Yes
No
(A) VISA IMMIGRATION STATUS:
(C) PRIMARY PURPOSE:
U.S. Immigrant/Permanent Resident
Studying in a degree program
F-1 Student
Studying in a Non-Degree program
J-2 Spouse or child of Exchange Visitor
Teaching
J-1 Exchange Visitor
Lecturing
H-1 Temporary Employee
Observing
Other, please specify
Consulting
Conducting Research
Training
(B) J-1 SUBTYPE
Student
Demonstrating Special Skills
Professor
Clinical Activities
Research Scholar
Temporary Employee
Short-Term Scholar
Here with Spouse
Other, please specify
Other, please specify
I hereby certify that all of the above information is true and correct. I understand that if my status changes from that which I have indicated on this
form I must submit a new Foreign National Information Form to UCF Human Resources, Employment Services & Records Department.
Signature:__________________________________________________ Date: ____________________________
13Nov2015