J VISA APPLICATION INSTRUCTIONS
INFORMATION:
If you wish to study at Longwood University for a semester or a year you need to complete the attached J Visa
application form. Once we have received and approved your application we will mail an acceptance letter, the
form you need to obtain a J-1 Visa (DS2019), and more information to help you prepare for your study.
Please refer to the additional information below as you complete each section of the application. If you have
questions about any part of the application please send an email to trentpf@longwood.edu
Section 1: Student’s Personal Data

When you complete this section, please provide an email address that you actively use.
Section 2: Current and Previous Study

Remember to attach to the application the certified copies of official transcripts and English proficiency
test scores (TOEFL, IELTS, Cambridge Test)
Section 3: Course Selection

We ask you to search the on-line course catalog to consider courses that you can take; however, do not
attempt to register yourself on-line. We will use the information you provide on the application to work
with an academic advisor to set your schedule. We will contact you if we have questions and you will
receive your course schedule before you arrive.
Section 4: Estimated Costs

We have provided an estimate of the typical university costs for exchange students. It does not include
travel and extra expenses. Also please note:
o students on 1-4-1 exchange agreements or partnerships do not pay tuition and fees to Longwood
but DO PAY housing and meal costs.
o students studying for one or two semesters as part of a special program must refer to the terms in
the university partnership agreement to determine required costs.
Section 5: Home Institution Information

Complete this section as directed on the form.
Section 6: Confirmation and Approval

Please print and sign the form using a blue or black ink pen. The application form and documents can be
scanned and sent by email with a printed copy sent by express mail.
International Student Application (J-1 Visa)
Please fill in the text fields and print and sign your name with a blue or black ink pen.
Application Deadlines: Fall Semester – April 1; Spring Semester – October 30
I. STUDENT’S PERSONAL DATA
Surname/Family Name: Click here to enter text.
PERMANENT ADDRESS (fill in below)
First Name: Click here to enter text.
Street: Click here to enter text.
Gender: ☐ Female ☐ Male
City: Click here to enter text.
Province/State: Click here to enter text.
DATE OF BIRTH (fill in below)
Month: Click here to enter text. Day: Click here to enter text.
Year: Click here to enter text.
Postal Code: Click here to enter text.
City of Birth: Click here to enter text.
Country: Click here to enter text.
Country of Citizenship: Click here to enter text.
Telephone: Click here to enter text.
Country of Legal Permanent Residence: Click here to enter
text.
E-mail: Click here to enter text.
Marital Status: ☐Single ☐Married
Name of emergency contact (family member
or close friend): Click here to enter text.
Do you wish to obtain a J-2 visa for your spouse or children?
☐ Yes ☐ No
Emergency contact e-mail: Click here to enter
text.
2. CURRENT AND PREVIOUS STUDY
Proposed period of study at Longwood University:
START DATE – Month : Click here to enter text. Year: Click here to enter text.
END DATE – Month: Click here to enter text.
Year: Click here to enter text.
Field of Study: (subject): Click here to enter text.
Your current grade average: Click here to enter text.
You must attach official transcripts.)
English language proficiency (If English is not your native language, please list your TOEFL or IELTS score):
Click here to enter text.
(You must attach a copy of your scores.)
3. COURSE (MODULE) SELECTION AT LONGWOOD UNIVERSITY
Please list below the classes (modules) you wish to take. We recommend that you take 12-16 credits. Because
not all classes are offered every semester and some classes may be full or there may be a time conflict with
others, please list alternative classes. You may find the course schedule for your term at this link:
https://sequoia.longwood.edu/bnr8prod/bwckschd.p_disp_dyn_sched
DO NOT ATTEMPT TO REGISTER FOR CLASSES ON-LINE.
1.Click here to enter text.
2.Click here to enter text.
3.Click here to enter text.
4.Click here to enter text.
5.Click here to enter text.
Alternate 1.Click here to enter text.
Alternate 2.Click here to enter text.
4. ESTIMATED COSTS OF STUDY AT LONGWOOD UNIVERSITY
Estimate your financial support (in U.S. dollars using the chart below. Your financial support must cover the cost
of room, board, and personal expenses. Attach documentation of your financial support (bank statements,
letters from your university, government).
Costs
Meals
Semester
$1,939.00
Year
$3,878.00
Housing
$3,197.00
$6,394.00
Books/Personal Expenses
$ 900.00
$1,800.00
Insurance*
$ 164.00
$ 328.00
$6,200.00
$12,400.00
Total
*Cost of minimum amount of insurance required of J visa holders, offered by International Student Insurance, a
plan we recommend. Insurance can be purchased on line at:
http://www.internationalstudentinsurance.com/schools/longwood-university.php
Funds from your college/university
$Click here to enter text.
Funds from your government
$Click here to enter text.
Funds from other organizations or loans
$Click here to enter text.
Personal and Family Funds
$Click here to enter text.
5. HOME INSTITUTION INFORMATION
Name and full address of your college/university: Click here to enter text.
INTERNATIONAL OFFICE OFFICIAL (fill in below)
Name: Click here to enter text.
Departmental Advisor (fill in below)
Name: Click here to enter text.
Telephone: Click here to enter text.
Telephone: Click here to enter text.
Fax: Click here to enter text.
Fax: Click here to enter text.
E-mail: Click here to enter text.
E-mail: Click here to enter text.
6. CONFIRMATION AND APPROVAL
You must print and sign the form using a blue or black ink pen.
Student Certification: I certify that all statements made on this application form are complete and accurate.
☐ Agree ☐ Disagree
Student Signature: ___________________________________________________
Student’s Name: Click here to enter text.
Date: Click here to enter text.
Official Approval: I certify that the above student is in good academic standing at this institution and is qualified
to study at Longwood University. I believe that this student will maintain high academic and ethical standards
and will cooperate with faculty and fellow students.
University Official Signature: __________________________________________
Name of University Official: Click here to enter text.
Date: Click here to enter text.
Please send by fax or e-mail with all information and signatures complete.
Please also send the original and an official transcript of grades by express mail to the following
address:
Patricia F. Trent
Director, International Admissions and
International Student/Scholar Services
Longwood University
201 High Street
Farmville, VA 23909 USA
Telephone: (434) 395-2599
Fax: (434) 395-2988
E-mail: trentpf@longwood.edu