DS-2019 Request Form for J-1 Exchange Visitor
Definition of the Exchange Visitor Status
The Exchange Visitor Program brings qualified research scholars and short-term scholars to the United
States for a variety of research purposes. The Exchange Visitor is under the sponsorship of an agency,
institution, or organization that has been approved by the United States Department of State.
The Space Telescope Science Institute Exchange Visitor program is defined as "a program to provide
courses of study, lecturing, and research opportunities, in the various fields of instruction and research
conducted by Emory University for foreign students, professors, research scholars and short-term scholars
to promote the general interest of international educational and cultural exchange."
Definition of Exchange Visitor "Research Scholar" Category
Exchange Visitor students must be admitted to a degree program at an accredited educational institution
for a full course of study or be engaged full time in a non-degree prescribed course of study. By
definition, students may be enrolled in degree programs, English language training and other non-degree
study preparatory to entrance into a degree program or some other non-degree program with a predetermined educational objective.
Eligibility requirements, Issuing Form DS-2019 and obtaining the J-1 Visa
Prior to issuing the DS-2019 form, it must be verified that the prospective exchange visitor:
(1) possesses English language proficiency;
(2) has adequate resources (for self and dependents) to complete his or her program;
(3) has substantial funding from any source other than personal or family funds.
Issuing Form DS-2019
Space Telescope Science Institute will issue a Form DS-2019 (Certificate of Eligibility for Exchange
Visitor Status) within 14 business days of receipt by our office. Unless other arrangements are
indicated, the official DS-2019 form and pre-arrival information will be sent directly to the prospective
exchange visitor.
Obtaining the "J" Visa
When the exchange visitor receives the form, he or she should go to the nearest U.S. Embassy or
Consulate to apply for a J-1 visa. If the Consular Office determines that the person is a bona fide
exchange visitor, the visa will be granted and the exchange visitor may come to the United States on the
J-1 visa. It should be noted that the Consular Officer is required to determine the intent of the applicant,
and the Consular Officer's determination and decision regarding the issuance of a visa are not subject to
appeal of any kind.
The Two Year Home Residency Requirement
Upon completion of an exchange visitor program in the United States, certain J-1 exchange visitors are
required to live in their home countries for a period of 2 years before they are eligible to apply for
immigrant status or for other nonimmigrant status. The 2 year home country residence requirement
applies to those Exchange Visitors who
(1) are financially supported by the U.S. government or their home governments; or
(2) have skills which are needed in their home countries, as specified on the Exchange Visitor Skills
List; or
(3) are medical doctors who have graduated from a foreign medical school and have come to the
United States to study or work in the field of medicine. The purpose of the home country
residence requirement is to enforce the return of exchange visitors in order to carry out the
educational exchange objectives of the program. Waivers of the residence requirement can be
granted under certain circumstances, but such waivers are difficult to obtain.
Duration of Status
30 day prior and after.
Employment
Employment is any type of work performed or services provided in exchange for money, tuition, fees
books, supplies, room, or for any other benefit. Employment for students is limited to 20 hours per week
while school is in session unless special circumstances exist particular to type of employment in which
student is engaged. There are two categories of employment available to J-1 students:
(1) student employment including employment required by a scholarship, fellowship, or
assistantship; on-campus jobs unrelated to study and off-campus jobs, necessary because of
serious, urgent and unforeseen economic circumstances and authorized by the Responsible
Officer; and,
(2) academic training, or, employment in the student's field of study authorized by the Responsible
Officer.
ENGLISH PROFICIENCY: Department of State regulations mandate that the Exchange Visitor possess
sufficient proficiency in the English language to participate in his or her program. Please be aware this
could impact your ability to receive a VISA..
My initials indicate I have read and understand the English Proficiency requirement.
Initial Here
MANDATORY HEALTH INSURANCE: The insurance coverage for the Exchange Visitor (and any
accompanying spouse or dependent) must be valid for the entire duration of the exchange program.
Minimum coverage shall provide medical benefits of at least $50,000 per accident or illness; repatriation
of remains in the amount of $7500; medical evacuation to the Exchange Visitor’s home country in the
amount of $10,000; and a deductible that does not exceed $500 per accident or illness.
My initials indicate I have read and understand the Mandatory Health Insurance requirement.
Initial Here
DS-2019 Request Form: (Rev. 11/19/2008)
Space Telescope Science Institute
3700 San Martin Drive
Baltimore, MD 21218
+1-410-338-4700 voice
+1-410-338-4477 fax
This is a request to:
Begin a New Program
Transfer of Program
NAME: (Family Name, First, Middle)
Information on this form MUST BE TYPED
This form should be returned to (by email of fax) Rueter@stsci.edu or Fax +1-410-338-4477.
STScI looks forward to your participation in our exchange visitor program.
BIOGRAPHICAL INFORMATION
The following information is necessary for STScI to prepare a DS-2019 for a visiting scholar to
obtain a new J-1 Exchange Visitor visa or to transfer to another program.
Sex: F
M
Date of Birth (MM-DD-YYYY):
**Social Security Number:
City of Birth:
Country of Birth:
Country of Legal Citizenship:
Country of Permanent Residence:
Dates of Appointment at STScI:
From:
To:
**If you have previously worked in the US, please provide your Social Security Number (ex: 123-45-6789).
US ADDRESS:
If you do not know your US address yet, you can use the Institute’s address; however, you must supply your local
address within 10 days of the address changing. For instance, if you will reside in temporary housing, you must supply your temporary
address within 10 days of moving to this address. After the temporary housing expires, you must provide your new address within 10
days of moving to your new address. THIS IS A FEDERAL REGULATION.
Street:
County:
City:
State:
Zip Code:
TWELVE-MONTH BAR:
The Department of State indicates that a professor or research scholar wishing to begin a new
exchange program is not eligible to do so if he or she was physically present in J status for all or part of the twelve (12) month period
immediately preceding the start of the new exchange program. Has the applicant been an Exchange Visitor in the United States at any
time within the past twelve (12) months?
YES
If yes, please list dates/attach copies of previous IAP-66 forms/DS-2019 forms.
NO
City and Country in which you are applying for the J visa (where the U.S. Consulate is):
DEPENDENT INFORMATION
Complete the following only if you wish to bring a dependent to the United States
Family Name:
First Name:
Middle:
Sex: F
M
Date of Birth (MM-DD-YYYY):
City of Birth:
Country of Birth:
Country of Legal Citizenship:
Country of Permanent Residence:
Relationship to You (Spouse or Child): Please Select One My Spouse will:
Travel With Me
Travel Separately
My Dependent will:
Travel With Me
Travel Separately
Family Name:
Sex: F
M
City of Birth:
Country of Legal Citizenship:
Relationship to You:
Please Select One
First Name:
Family Name:
Sex: F
M
City of Birth:
Country of Legal Citizenship:
Relationship to You:
Please Select One
First Name:
Middle:
Date of Birth (MM-DD-YYYY):
Country of Birth:
Country of Permanent Residence:
My Dependent will:
Travel With Me
Travel Separately
Middle:
Date of Birth (MM-DD-YYYY):
Country of Birth:
Country of Permanent Residence:
My Dependent will:
Travel With Me
Travel Separately
Please list the address Human Resources should mail your DS-2019 to:
Telephone Number:
Fax Number:
Email:
PREVIOUS EDITIONS ARE OBSOLETE
Revised (11/08)