KENTUCKY STATE UNIVERSITY
Office of International Affairs Cooperative Extension Building 109
400 EAST MAIN STREET FRANKFORT, KENTUCKY 40601
Yes No Has been participating in cultural activities as required by the J-1 federal regulations
No Has been participating in cultural activities as required by the J-1 federal regulations
List of cultural activities:
Supervisor's name___
Title:_____ Department:_____
Email:_____Phone: __________ _____
Signature: _____ Date: _____
IN ALL THINGS EXCELLENCE
Kentucky State University is an equal educational and employment opportunity/affirmative action institution.