College of Agriculture and Life Sciences
International Visitors
PLEASE NOTE: This document should be sent to the foreign national visitor upon receipt of notification of the visit.
Dear (Scholars Name):
Welcome! Dr. (Professor) has informed me that you will be coming to Cornell University as a (Title). Attached is the required
information needed to obtain a J-1 visa. Once complete, please email your signed offer letter and required visa documents to
(name and email address). If you have any questions regarding your visa application please contact (name HR Rep and email
address).
I will need you to complete and provide the following information:
COMPLETE:

Initial J1 initial application form. Please access the web link noted below to print the form. You will only need to
complete pages 2 and 3. If you will be bringing a spouse or child(ren), you must also complete page 4.
http://www.isso.cornell.edu/academicstaff/jscholarrequestform.pdf.

Send the completed form and the necessary supporting documents securely to [HR Reps Name] [HR Reps Email
Address] using https://app.box.com/signup/o/default_personal_offer. Disregard page 5 if you currently do not
hold a visa. Please note that the DS-2019 (the document required to obtain a J-1 visa) may take up to 3-4 weeks
to process and send after submission to our International Students and Scholars Office (ISSO).
Please be aware of the minimum funding requirements:
$1,300.00 per month for individual
$650.00 additional per month for spouse
$375.00 additional per month for each child
$1200.00 one-time initial adjustment and settling expense
PROVIDE:

Proof of financial support – either from your home Institution or other funding source, or personal monies (the
amount is calculated based on initial expense plus a monthly required amount detailed on the J-1 request item
#18.

Medical insurance at the minimum levels required (see attached document for more details).

Copy of your Curriculum Vitae (CV).

Copy of your passport (and for your spouse and child(ren) passports, if applicable).

Pay Visiting Fellow/Scholar fee of $1,000 (if applicable).
NOTE REGARDING START DATE: J1 Scholars must enter the U.S. and report to Cornell’s ISSO no more than 30 days before
and NO MORE than 30 days after the start date on the DS-2019. Please inform me if you will not arrive on time so that I may
notify the ISSO.
Please let me know if you have any questions. We look forward to you joining the Department of (Dept. Name) and Cornell
University.
Thank you,
Signature
International Students and Scholars Office
Cornell University
B-50 Caldwell Hall, Ithaca, NY 14853
Telephone: 607 255-5243 Fax: 607 255-2778 Web:
www.isso.cornell.edu
J-1 Scholar Initial Request Form
Important Information – Please Read:
J-1 Professor/Research Scholar Category – Eligible for 5-year maximum stay in teaching, research, or both. There
are some individuals who may NOT be eligible for a new J-1 Professor/Research Scholar. These restrictions or “bars”
are listed below:
2-Year Repeat Participation Bar – J-1 Professors or Research Scholars are required to have a gap of 2years between the end of any previous J-1 Professor/Research Scholar Program and the beginning of any
new J-1 Professor/Research Scholar Program. Therefore, those beginning new programs that will include
repeat visits should have their programs extended for the full duration of their program/collaboration, up to
the 5 year maximum, even if portions of that time will be spent outside the US. For those not eligible for a
new J-1 Professor/Research Scholar program, consider whether the J-1 short-term scholar (see below) will
meet your needs.
12-Month Bar – An individual who has been in any category of J status (including J-2 and J-1 student) for
more than 6 of the 12 months immediately preceding the new program start date, is ineligible for a J-1
Professor/Research Scholar category. For those not eligible for a new J-1 Professors or Research Scholars
program, consider whether the J-1 short-term scholar (see below) will meet your needs.
J-1 Short Term Scholar Category – Eligible for 6-month maximum stay, no extensions or changes of status to
another visa classification within the US allowed.
2-Year Home Residency Requirement – Will apply to any J-1 who receives US or home country government
funding for the exchange (note that salary from federal grants is not considered government funding unless the
funding was provided for the purpose of the exchange), or who is participating in a field of specialization which their
home country has listed on the US Department of State’s “Skills List.” Affected individuals are not eligible for H1B (or
L) visas, for US permanent residence, for changes of visa classification within the US, unless they return home for 2
years, or obtain a waiver of the requirement. They are not prohibited, however, from new J programs (if otherwise
eligible), or other visa classifications.
Please consult with the ISSO, if you have any questions about these requirements.
ISSO Process: - The ISSO will strive to complete your request within one (1) business week. In periods of heavy
traffic, we may exceed this target. We may also be in a position to move faster. However, you can reasonably expect
to have your request complete within one business week.
J-1 Scholar Initial Request Form: This is not an Immigration document. DO NOT SEND IT TO YOUR VISITOR. All
questions must be answered in full to avoid delays in processing Form DS-2019. Type or print. This form must be
completed by an HR representative
YOUR NAME EXACTLY AS WRITTEN IN YOUR PASSPORT* (please send a copy of your passport identification
page with this form so that we may verify the accuracy of your name and avoid the possibility that you will experience
delays in obtaining your visa stamp. If you choose to send this form by email, please FAX the passport copy to:
Sharon Van De Mark at 607-254,1222.)
[*If your name is not exactly as it is written in the passport, you may be denied a visa.]
1. Name of International EXACTLY as written on his/her passport* (obtain copy for your records): [*If the
name is not exactly as it is written in the passport, the visitor may be denied a visa.]
____________________________________________________________________________________
Family (Last)
Given (First)
Middle
2. Date of Birth ________(month)________(day)_______(year)
3. Gender:
[ ] MALE
[ ] FEMALE
4. City of Birth _______________________
(city)
5. Country of Birth:______________________________
6. Country of Citizenship: _____________________________
7. Country of Legal Permanent Residence: ___________________________
8. Email Address: __________________________________________
9. Current Job or Position in Home Country:_______________________________________________
Was/Is the employer:
[ ] Educational Inst. [ ] Private Business [ ] Central Gov't. [ ] State Gov't.
[ ] Regional Gov't. [ ] City Gov't.
10. Exchange Visitor Category Requested (check one, see Page 1 for details)
____ Professor/Research Scholar (5-years maximum, 2-year repeat participation rule applies)
____Short-Term Scholar (6-month maximum, 2-year repeat participation rule does NOT apply, but no
extensions or changes of status possible within the US – e.g. to H1B)
11. Complete Foreign Address: (required)
12. DO YOU HAVE A PHD?
[ ] YES [ ] NO*
*If no, please note that all J-1 scholars are expected to hold advanced degrees and be well-established in their
discipline. It is the responsibility of the hiring department to determine the appropriate academic title and to ensure
that you meet all educational requirements for the position before the DS-2019 request form can be created.
13. HAVE YOU BEEN IN ANY J STATUS PREVIOUSLY? [ ] YES* [ ] NO
*If yes, please provide copies of your previous DS-2019 forms, and list the dates of presence in the US in J
status, below:
14. LENGTH OF STAY for this J1 request
Start Date: ____________________
End Date: _____________________
SOURCE(S) AND AMOUNT OF FINANCIAL SUPPORT FOR YOUR STAY
The U.S. Government requires that Cornell verify adequate financial support and health insurance for all J visitors
and their accompanying dependents before issuing a DS-2019 Form. See below for minimum amounts required. It
is the hosting or hiring department's responsibility to verify that ALL exchange visitors meet minimum funding
guidelines and are covered by medical insurance. Please note that medical insurance is a U.S. Government
requirement.
If you are submitting evidence of funding that is not being provided by Cornell, please indicate the sources of funding
for the J-1 exchange, and provide the hiring department with copies of funding letters or bank statements (not more
than 6 months old), so that verification of minimum funding levels can be determined. Please send these by FAX to
the number indicated on the first page of this form:
MINIMUM FUNDING REQUIREMENTS:*
$1,300. / per month for individual
$650. / per month for spouse
$375. / per month for each child
$1200 / initial adjustment expenses
Source of Financial Support (Enter amount in US$ for the entire period of stay)
$___________ Cornell University
$___________ International Organization (name of org.) ________________________
$___________ U.S. Gov't Agency** (name of agency) ________________________
$___________ J1 Scholar's Government
$___________ All other organizations (name org) ________________________
$___________ Personal Funds
*This funding may come from any source including the visitor’s personal savings or Cornell salary. These amounts represent the
bare minimum for someone who might be willing to share an apartment, and do not include the cost of health insurance coverage,
which can be very expensive!
**U.S. Government Funding: The Exchange Visitor is considered to be government funded ONLY if s/he received funds directly from
a U.S. Government agency. When individuals are supported through government funds paid to a Cornell professor, department, or
grant, this is NOT considered to be direct government funding.
BRINGING FAMILY MEMBERS
We require the following data for EACH of the dependents (spouse and child(ren) under the age of 21) who will be
accompanying you:
1. NAME OF INTERNATIONAL EXACTLY AS WRITTEN ON HIS/HER PASSPORT*
____________________________________________________________________________________
Family (Last)
Given (First)
Middle
2. DATE OF BIRTH ________(month)________(day)_______(year)
3. GENDER: [ ] MALE
[ ] FEMALE
4. City OF BIRTH _______________________
5. Country of Birth:______________________________
6. COUNTRY OF CITIZENSHIP: _____________________________
7. COUNTRY OF LEGAL PERMANENT RESIDENCE: ___________________________
8. Relationship to J-1? [ ] Spouse [ ] Child
1. NAME OF INTERNATIONAL EXACTLY AS WRITTEN ON HIS/HER PASSPORT*
____________________________________________________________________________________
Family (Last)
Given (First)
Middle
2. DATE OF BIRTH ________(month)________(day)_______(year)
3. GENDER: [ ] MALE
[ ] FEMALE
4. City OF BIRTH _______________________
5. Country of Birth:______________________________
6. COUNTRY OF CITIZENSHIP: _____________________________
7. COUNTRY OF LEGAL PERMANENT RESIDENCE: ___________________________
8. Relationship to J-1? [ ] Spouse [ ] Child
1. NAME OF INTERNATIONAL EXACTLY AS WRITTEN ON HIS/HER PASSPORT*
____________________________________________________________________________________
Family (Last)
Given (First)
Middle
2. DATE OF BIRTH ________(month)________(day)_______(year)
3. GENDER: [ ] MALE
[ ] FEMALE
4. City OF BIRTH _______________________
5. Country of Birth:______________________________
6. COUNTRY OF CITIZENSHIP: _____________________________
7. COUNTRY OF LEGAL PERMANENT RESIDENCE: ___________________________
8. Relationship to J-1? [ ] Spouse [ ] Child
1. NAME OF INTERNATIONAL EXACTLY AS WRITTEN ON HIS/HER PASSPORT*
____________________________________________________________________________________
Family (Last)
Given (First)
Middle
2. DATE OF BIRTH ________(month)________(day)_______(year)
3. GENDER: [ ] MALE
[ ] FEMALE
4. City OF BIRTH _______________________
5. Country of Birth:______________________________
6. COUNTRY OF CITIZENSHIP: _____________________________
7. COUNTRY OF LEGAL PERMANENT RESIDENCE: ___________________________
8. Relationship to J-1? [ ] Spouse [ ] Child
J Visa Holders-academic visitors not on Cornell payroll-Health Insurance
Cornell University requires that you have a medical insurance policy protecting you and your
family in the event of a major illness or injury. U.S. Government regulations also mandate that
all exchange visitors (J-1 visa holders) and their dependents (J-2) must have health and
accident insurance in order to participate in Cornell's Exchange Visitor Program. In addition,
federal regulations prohibit an extension of your J-1 status beyond the dates on the IAP-66 form
without proof that you have maintained insurance for yourself and all family members during
your entire length of stay in the U.S. as an exchange visitor. Students/Scholars and their
families may substitute a comparable external insurance plan for the Cornell plan, if it meets the
minimum coverage requirements outlined below.
MINIMUM LEVEL OF INSURANCE COVERAGE REQUIRED
 medical benefits of at least $50,000 per accident or illness
 a deductible not to exceed $500 per accident or illness
 repatriation of remains in the amount of $7,500
 expenses associated with the medical evacuation to home country in the amount of
$10,000
If you have external insurance for yourself and your family which meets the above four
requirements, you must bring written evidence of such coverage to the ISSO (International
Students & Scholars Office) upon arrival to Cornell (new scholars only) or before an extension
of J-1 status can be prepared (continuing scholars). The evidence must include documentation
from your insurance company which shows the beginning and ending dates of coverage, the
above four minimum requirements, and coverage for any dependents you have with you in the
U.S. If your policy is not written in English, please also bring in a translation (your own
translation is permissible) of the relevant portions. If the amounts of coverage are not stated in
US dollars, please calculate the conversion.
Please note: In the United States certain kinds of elective medical care, such as eyeglasses or
dentistry are ordinarily NOT covered by insurance and can be very expensive. Exchange
Visitors should take care of those needs before leaving home.
Scholars: Cornell has a medical insurance plan that most exchange visitors (not all) with
academic appointments for 6 months or longer may join. Eligibility depends on the conditions of
your appointment. Contact Benefit- Services, Office of Human Resources (130 Day Hall) for
further information. You are required to make alternative plans to ensure required coverage for
your entire visit if Cornell does not provide insurance for you. Arrangements for this coverage
can be made using private insurance programs (http://www.insuremytrip.com/). Note: it is more
reasonable to purchase policies through private companies for unpaid appointments greater
than 6 months, rather than Cornell.