J-1 Request To Transfer Host For J-1 Scholar Or Intern Form
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1
2Center For International
Education
865.974.3177
1620 Melrose Avenue
Knoxville, TN 37996-3531
J-1 Request to Transfer Host
For J-1 Scholar or Intern
NOTE:
•
You must submit this form and your current I-20/DS-2019 so that the CIE can verify and/or update your SEVIS record. When
appropriate, the CIE will then sign your I-20/DS-2019.
If there are any university holds on your record, the CIE will not sign your I-20/DS-2019. Please clear all holds before submitting
•
this request.
An international scholar requesting an extension of J-1 status should complete this form and submit to host department. Host
•
Department should then send it to the Center for International Education with “J-1 Extension Request (Form A).”
Name ____________________________________________________________________________________ UT ID _________________________________
Family/Last
Given/First
Local Address _________________________________________________________________________________________________________________________
Street
Apt. #
City
State, zip
If you have moved, please fill out a change of address form at the CIE immediately.
Phone (h) ___________________________________________
UT e-mail ___________________________________________
SEVIS ID# ___________________________________________
Major ________________________________________________
Does CIE have the latest copy of your I-94, I-20/DS-2019, and F-1/J-1 visa?
Yes
No
If not, please bring these documents in so that we can update your immigration file.
Current degree level (please check one): Bachelor’s
Master’s
Doctorate
Important: When a J-1 scholar or intern comes to UTK, he/she is assigned to a host professor or other staff member
for the duration of the visit. Sometimes it is necessary to change the host assigned to the scholar or intern. This is
allowed as long as the activities and “program goals” of the scholar/intern will not change substantially, and as long
as the new host professor agrees to take on the responsibility of the host.
If the host will change, this form should be completed and signed by the new host and the department head and sent
to The UT Center for International Education, 1620 Melrose Avenue (3531).
1. Name of Scholar/Intern:
2. Host Department
If host department will change, give name of new department, but call the Center for International Education to discuss
before completing form. Normally, the host department should not change
3. Intended Dates of Scholar/Intern’s J-1 Program with new host, from ________/________/________ to ________/________/________
4. Short description of program (e.g. “research in plant genetics”)
____________
5. Name of new host professor/staff member
___
6. Telephone number
7. E-Mail
______
8. Reason for change:
Previous host professor/staff member is leaving UTK
Interests of the new host more closely match those of the scholar/intern
Other:
______
Revised March 2014.
I:\Int'l Students and Scholars\Website\New Website\Forms\Scholar Forms\Scholar Forms - Revised and Fillable
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