Academic Training Request Form Page 2

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Advisor Section
This student is applying for Academic Training authorization. Federal immigration regulations allow students in J-1 status to apply for Academic
Training permission to gain experience in the U.S. through employment/internship/training opportunities related to their studies. Please
complete this section about the training opportunity.
Name of Training Supervisor:___________________________________ Name of Academic Training Site:______________________________
Academic Training Site Address:
Street Address___________________________________ City_______________ State______ Zip Code ______________
Number of Hours Per Week: _______ Training Begin Date: ____________ Training End Date: ______________
Stated goals and objectives of Academic Training Program:
Describe how the Academic Training relates to student’s major field of study:
Why is this Academic Training opportunity an integral or critical part of the student’s academic program?
Student is expected to complete his/her educational objective __________________quarter, 20___________________
Advisor Name: ________________________________ Phone:_______________________ Email:___________________________
Signature:_____________________________________________________________Date:________________________

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