J-1 Exchange Visitor: DS 2019 Department Request Form This form is used to notify ISSSO of your department’s intent to bring a foreign national to KSU to engage in periods of paid or unpaid research, teaching, or other academic activity as a J-1 Exchange Visitor. Please Note: J-1 documents cannot be issued for tenure track positions. Family Name: First Name: Exchange Visitor’s Name Middle Name: Suffix: Start Date: Dates of Activity at KSU: End Date: Department: Host Professor: Host Department/School Email: Information Telephone: Dept. Budget Speed-type Purpose of Form Begin a New Program [ ] Extend current J-1 status [ ] (please check one) Transfer to KSU [ ] Research Scholar [ ] Exchange Visitor Category Professor [ ] Short-term Scholar (6 mo. limit) [ ] (please check one) Specialist [ ] Detailed Activity Description: $ Kennesaw State University: Agency Name: U.S. Government Agency: $ Exchange Visitor’s Financial Resources Organization Name: (Federal J-1 regulations require International that the foreign national have Organization: $ enough funding for the entire duration of his/her J-1 $ Exchange Visitor’s program.) Government: $ Other Organizations: $ Personal Funds:
J-1 Exchange Visitor: DS 2019 Department Request Form This form is used to notify ISSSO of your department’s intent to bring a foreign national to KSU to engage in periods of paid or unpaid research, teaching, or other academic activity as a J-1 Exchange Visitor. Please Note: J-1 documents cannot be issued for tenure track positions. Exchange Visitor’s Name Family Name: First Name: Middle Name: Suffix: Dates of Activity at KSU: Start Date: End Date: Host Department/School Information Department: Host Professor: Email: Telephone: Dept. Budget Speed-type Purpose of Form (please check one) Begin a New Program [ ] Extend current J-1 status [ ] Transfer to KSU [ ] Exchange Visitor Category (please check one) Research Scholar [ ] Professor [ ] Short-term Scholar (6 mo. limit) [ ] Specialist [ ] Detailed Activity Description: Exchange Visitor’s Financial Resources (Federal J-1 regulations require that the foreign national have enough funding for the entire duration of his/her J-1 program.) Kennesaw State University: $ U.S. Government Agency: Agency Name: $ International Organization: Organization Name: $ Exchange Visitor’s Government: $ Other Organizations: $ Personal Funds: $