J-1 Request To Transfer Host For J-1 Scholar Or Intern Form Page 2
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1
2Center For International
Education
865.974.3177
1620 Melrose Avenue
Knoxville, TN 37996-3531
9. Will the source of funding for this scholar/intern change from the information on the original J-1 Request
No
Yes
(If yes, Call CIE to discuss)
10. Approval by New Host Professor: I certify that this visitor will be associated with me for the dates listed in
Question 3 above. I will ensure that he/she is included in the activities of this department. If the visitor leaves early or
is absent for more than 30 days, I will inform my Department Head and/or the UT Center for International
Education.
Host Professor Signature _______________________________________
Date ________/________/________
Print Name _______________________________________
11. Approval by [new] Department Head: I will [continue to] ensure that this visitor is included in the activities of this
department for the duration of his/her program.
Will this scholar be exposed to technology, equipment, software, or information a ) listed on the Commerce Control List
(CCL) of the Export Administration Regulations (EAR) or b) subject to the International Traffic in Arms Regulations (ITAR)
listed as a Defense Article or Technical Data on the U.S. Munitions List (USML), or otherwise designed, developed,
configured, adapted or modified for military application?
Yes
No
[If yes, explain on a separate sheet.] If you are not sure, please consult the UT Export Control Officer at 974-0232.
IMPORTANT: I will inform the Center for International Education if the visitor is terminated from employment or
leaves The University more than 30 days earlier than the date given above or if the visitor is absent from The
University for more than 30 days.
Department Head Signature _______________________________________
Date ________/________/________
Print Name _______________________________________
12. Agreement by Scholar: I understand that the professor named above will be my host professor; I agree to work him/her
and inform him of any future change in my plans.
Scholar Signature _______________________________________
Date ________/________/________
Print Name _______________________________________
For questions, please contact the Center for International Education (CIE) at (865) 974-3177.
For CIE Us e Only
FSA Atlas Updates
Yes No
Enrollment Status: Full-time:
Bio: Yes
Program: Yes
Holds: Yes No
____________________________
Financial: Yes
Address: Yes
Date Cleared _________________________
Notes __________________________________________________________________________________________
Reviewed by ______________________________________
Date ____________________________________
Revised March 2014.
I:\Int'l Students and Scholars\Website\New Website\Forms\Scholar Forms\Scholar Forms - Revised and Fillable
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