Please enter your details in the form below to apply for the J1 2008 programme.
When all fields have been completed please print off the generated PDF, sign it, get it stamped by your college and return it by post to...
USIT, 13B College Street, Fountain Centre, Belfast, BT1 6ET .

***If you do not have adobe acrobat reader installed (PDF), download here... download adobe acrobat

Student Details (Enter details exactly as appears on passport)

Fields marked * are mandatory

First Name*:

if your middle name does not appear on your passport, then you may leave middle name blank

Middle Name:

Last Name*:

Gender*:

Must 18 years of age on 20th May 2008

Date of Birth*:

dd/mm/yy

Address*:

County/Post Code:*

City of Birth:*

Country of Birth:*

Citizen of:*

Legal Residence of:*

Landline telephone number:

Mobile*:

Primary EMail *

We encourage you go give an alternative email address to ensure USIT reach you. You may use a friend or a family member address.

Secondary EMail *

Passport Details

Passport Number:

Passport Issue date:

dd/mm/yy

Your passport expiry date must be greater than your length of stay in the U.S

Passport Expiry date:

dd/mm/yy

College Details

Your current college year is

Year of a

Year Course

If your college is not on the list then please type in box provided

Name of college:

Erasmus/Socrates Prog:

Yes No

Next of Kin / Emergency Contact

First Name:

Last Name:

Address*:

County/Post Code:*

Country of Birth*:

Landline Phone Number:*

Mobile Phone Number*:

E-mail Address:

Work and travel Dates

US Arrival Date*:

dd/mm/yy

U.S arrival date should be after the 20th May 2008 = See help

DS-2019 start date:

dd/mm/yy

This is the work start date that will be printed on official work authorisation document (DS-2019) This date cannot be changed so please CONSIDER VERY CAREFULLY.

US Depart Date:

dd/mm/yy

Please ensure that you passport expiry date is greater than the date you choose to enter for US depart date

Select amount of previous visas

Name of Programme:

Name of Sponsoring organisation:

Programme number:

Dates of previous DS-2019:

to:


Name of Programme:

Name of Sponsoring organisation:

Programme number:

Dates of previous DS-2019:

to:


Name of Programme:

Name of Sponsoring organisation:

Programme number:

Dates of previous DS-2019:

to:

J1 Options & Funding

J1 Programme Application

Programme Fee

SEVIS Fee:

Total outstanding:

****The minimum amount due now is a deposit of £214 ***

Have you ever applied for a visa to emigrate permanently to the US:

yes no

Have you ever been arrested or convicted of a crime:

yes no

Have you ever been refused a visa by a US embassy:

yes no

If you answered yes to any of the 3 questions above, please refer to www.studentravel.com for further information

You must tick box to indicate that you have read the Terms and conditions