DS-2019 Application - Instructions

Visiting Professors, Research Scholars, Short Term Scholars and Specialists

 

NOTE:  Professors and Research Scholars may remain in the U.S. in J-1 status for up to three years.  In some limited instances, an extension beyond the three-year limit is possible. Short Term Scholars may remain in the U.S. for a maximum of only six months and no extension of stay is permitted.  Specialists are limited to a stay of one year, with an extension possible only under exceptional circumstances and with Department of State approval.  Therefore, it is important for the department to determine the duration of the proposed stay before completing this form.

Procedure:

Hosting UW-Madison Department:

• Approves (after Dean/Division clearance as necessary) International Exchange Scholar invitation and J-visa request
• Completes DS-2019 request form including attachments, as required
• Forwards completed application packet to IFSS.

IFSS:

• Processes completed application packet
• Produces DS-2019 (approx. 10 working days)
• Dispatches visitor's DS-2019 packet as instructed by department
• Upon visitor's check-in at our office, copies immigration documents/schedules orientation

Visitor:

• Takes DS-2019, passport, UW appointment/invitation letter, and any other required financial documents to U.S. Consulate to obtain J-1 visa stamp in passport;
• Uses DS-2019 and passport with J-1 visa stamp to enter the U.S.
• Checks-in with IFSS for required registration and to schedule orientation/welcome session

DS-2019 application (with all required attachments) may be dropped off, mailed or faxed (originals to follow by mail) to IFSS. We will not process an incomplete application; instead, it will be returned to you for completion and resubmission. To avoid this, be sure to include:

• DS-2019 application form fully completed and signed by the department
• Copy of Dean/Division approval notice if applicable
• Copy of invitation/offer letter from the hosting UW-Madison Department on letterhead and signed
• If not 100% funded by UW-Madison, documentation of all other funding source(s): e.g. letter(s) from official sponsor or official bank statement (in English or with English translation) on letterhead
• Copy of passport information page for J-1 scholar and all dependents
• For courier service delivery of DS-2019 to scholar:  Completed airbill

Special Notes:

• For J-1 visa holders already in the U.S. a visa transfer may be required/allowed; contact IFSS for information.  If a transfer is permissible: include copies of all DS-2019s for current (and past, if applicable) program(s), copy of passport expiration page, and copy of I-94 card.
• For visitors who are M.D.s: a "5 point" letter from the Chair and Director of Clinical Affairs is required if the visit will involve incidental patient contact.

Questions:   Ischolars@bascom.wisc.edu. Or call IFSS at 265-4000

DS2019 Application
Certificate of Eligibility for J-1 Scholar Visa: 
Professor, Research Scholar, Short Term Scholar or Specialist

To begin a J scholar program at UW-Madison (for scholar not in the U.S., or in U.S. on other J-1 program)
(For extension or updates, please contact IFSS for more information.)

NOTE: Short Term Scholars may not stay in the U.S. for more than six months. No extension of stay is permitted. If the total visit may extend beyond six months, please check here _____.

NOTE: Names of J-1 scholar and all dependents must appear exactly as in current passport.

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Section 1:   Information about the Scholar
(Department or visitor may complete. Please print clearly.)

Name:
last/family___________________________  
first/given___________________________
middle_____________________

Gender (check one)   o  Male  o  Female  
Date of Birth     m/dd/yy
City of Birth
Country of Birth

Citizenship*
*If scholar has dual citizenship, list country of passport in use for this visit.  
Country of Permanent Residence
Title/position in home country
Institution/employer in home county
Highest (equivalent) degree held by visitor (check one):
o Ph.D. o Masters o MD o other (list)____________________

Visitor (check one):
o has   o has not  previously been in the U.S. in J-1 or J-2 status.

If "has," list dates of program(s), and  Attach: copy of all previous IAP-66 forms.

Current mail address (with fax, e-mail if available)
_____________________________
_____________________________
_____________________________
_____________________________

Prospective UW-Madison dept. address
_____________________________
_____________________________
_____________________________
_____________________________
_______________ Building #_____

Accompanying Family Members (list only if traveling and entering the U.S. with the scholar)

(Legally wed spouse and minor unmarried children under the age of 21.)

Name         Relationship           Birth Date       City & Country of Birth       Citizenship

Questions:  Ischolars@bascom.wisc.edu or Kim Maday at 265-5114 or Deborah Ahlstedt at 265-4000

Section 2: Information about the Appointment:
(UW-Madison host department to complete. Please print clearly.)

Dates of Program: 
Beginning (mm/dd/yy)
Ending (mm/dd/yy)

UW Title offered  ________________________
Host department ________________________

Attach: Copy of offer letter (if funded) or invitation letter (if non-funded/honorary position). The Exchange Visitor will need the original at the U.S. consulate and the port of entry.

Visitor's primary UW activity (check one): 
o  Teaching  o  Research  o  Observation  o Consultation

Visitor's field of specialization _________________________________________________
Visitor will be supervised at UW-Madison by ______________________________________
Supervisor's telephone _______________________
E-mail ___________________________

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Section 3: Funding Information (US dollars):

Attach: letter(s) or official bank statement in English to substantiate each funding source below.

UW-Madison salary/stipend, if any: 
$________________(check one)   o per month  o for duration of program

The UW-Madison sponsor (check one):
o has   o has not   received funding from U.S. Government Agency(ies) to support this exchange visitor.  If "has" indicate agency(ies) below.

U.S. Government (list agency) ______________________  $____________________ per________
International Organization  (list agency) _______________  $____________________ per________
Visitor's home Government:   $____________________ per________
Visitor's personal funds:   $____________________ per ________
Other (specify):  __________________________________  $____________________ per________

Total:  $___________________   per________

Insurance coverage for the duration of the program (check one):

o   Visitor will purchase SHIP plan through UW-Madison.  

o   UW-Madison appointment includes health insurance; visitor will apply to SHIP for waiver.

o   Visitor has other insurance and will apply to SHIP for waiver.

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Section 4:  Department Approval

Name, Title of Dept. Hiring Appointing Authority:
Name of Department Contact Person:
Contact Telephone / E-mail address:

Signature: ________________ Date_______________

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Dispatch instructions (check one) :

o Departmental Pick-up.

o Express or courier service to visitor.

Send IFSS correspondence to (check one):

o Department Contact person (name): ____________

o Supervising professor/staff.

o Hiring Authority.

 

Attach:  Completed airbill

Updated 4/16/2003