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Request Form & Instructions
Request Form & Instructions
Instructions
Preparing Documents to Request an Initial DS-2019
The Office of International Affairs (OIA) administers Nova Southeastern University’s Exchange Visitor Program.
Programs seeking to host a foreign scholar should complete the following form along with the requested supporting
documentation for submission to OIA.
In order to allow for administrative processing and in anticipation of visa application processes at American
embassies/consulates, please submit your request at least 60 days prior to the visitors anticipated appointment start
date.
Exchange Visitor Categories: This request form is only for the purpose of requesting the following classification or
category of visitors under the J-1 Exchange Visitor Program: 1) Professor, 2) Research Scholar, and 3) Short-Term
Scholars:
For detailed information on these exchange visitor categories, please visit our website: www.nova.edu/jscholars
Required Supporting Documentation: Along with the attached form, please ensure you also include the following
documents. Please submit all together in one email.
1) the completed and signed J-1 Scholar request form
2) a letter of invitation
3) proof of adequate funding
4) a copy of the scholar’s C.V. or résumé
5) certification of English language proficiency
6) copies of passports for both visitor and dependents (if any)
7) copies of previous DS-2019s (if any)
8) Program Attestation of Cultural Exchange
9) Exchange Visitor attestation of insurance
10) Exchange Visitor’s foreign address
11) Exchange Visitor’s foreign telephone number
For detailed information on all supporting documentation, please visit our website: www.nova.edu/jscholars
NEXT STEPS?
● After you have completed the attached form, email it to [email protected] including the required
supporting documentation.
● The OIA will review the request, determine the eligibility of the visitor, and prepare the initial DS-2019.
● The OIA will email the initial DS-2019 to the scholar at the email address included below, along with the
NSU sponsor. That email will contain the next steps the scholar needs to take before entering the United
States.
J-1 Exchange Visitor Request Form
(For Research Scholar, Professor, or Short-Term Scholar)
10. Has the candidate been a J-1 scholar in the US? Yes No End date of most recent J-1 program
13. Brief, concise, non-technical description of activities of exchange visitor at NSU (and work site address) :
For example: Research in the field of veterinary pathobiology, research in mathematics, etc.
14. Source and amount of financial support: Please note that this must be documented in the form of an offer
letter or, if the support is coming from the home institution or agency, documentary evidence must be attached to
this application before the OIA can prepare the scholar’s documents.
● Nova Southeastern University $ Source:
(includes departmental grant funding)
● Exchange visitor’s government $ Source:
● Other organizations (please list) $ Source:
● Personal funds $
15 Accompanying Family Members – If the exchange visitor’s spouse and/or children will accompany him/her
to NSU, the OIA must also issue to the exchange visitor, a certification listing the names (as they appear in their
passports) of the family members, their relationships to the exchange visitor and the dates and places of birth (city
and country). Each dependent will be issued his/her own J document, DS 2019, as a J-2 dependent.
Dependent #1
(Last or family name) (First name) (Middle name)
Relationship Date of Birth month/day/year Place of birth:
Spouse, City &
daughter, son Country
Country of Citizenship Country of Permanent Residency
Dependent #2
Dependent #3
Note: If more space is needed for additional dependents, please attach an extra sheet of paper. Be sure that all names
are spelled correctly and exactly as they are in the individual’s passport. A misspelling of a name can lead to a visa
denial.
17. Information on Additional NSU Department Contacts responsible for hosting the Visiting Scholar:
Name (Student Supervisor): Title:
HR Signature: Date: