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| Start date of current J-1 Status: ________ through ________ mm/dd/yyyy | ||
| Program Sponsor (name/program number found on line 2 of DS-2019): ________ | ||
| If in J visa status, have you applied for a waiver of 212 (e), the 2 year home residency requirement? ☐ Yes ☐ No | ||
| If you have applied for the waiver, has it been approved? ☐ Yes ☐ No (if yes, please include a copy of waiver) | ||
| Section 2: Financial Information | ||
| The minimum support for a single visitor is 1,500 per month, plus 625 per month for a spouse and 375 per month per child. If support is not from Kentucky State University, attach documentation in English with amounts in US Dollars. | ||
| Sources of Funds | Name of Source of Funding | Amount (In US Dollars) |
|---|---|---|
| Kentucky State University | ||
| International Organization | ||
| Exchange Visitor Gov't | ||
| Other Organization | ||
| Personal Funds | ||
| Section 3: Dependent Family Information | ||
| If you require visa documents for your spouse or children, please complete this section. Important Notes: • DS-2019 documents can be issued only to dependent spouses and to unmarried, dependent children under 21 years of age. Married children and children over 21 years old cannot be issued a DS-2019 and cannot hold J-2 status. | ||
| Spouse's Information Full Name (as in passport): ________ Last/Family Name ________ First/Given Name ________ Middle Name (if any) ________ | ||
| Date of Birth ________ mm/dd/yyyy | Gender: ☐ Male ☐ Female | |
| Place of Birth ________ City ________ Province/State ________ Country ________ | ||
| Citizen and Residence: ________ Country of Citizenship ________ Country of Permanent Residence ________ | ||
| Email Address: ________ | ||
| 1st Child's Information\nFull Name (as in passport): ________ Last/Family Name ________ First/Given Name ________ Middle Name (if any) ________ | ||
| Date of Birth ________ mm/dd/yyyy | Gender: ☐ Male ☐ Female | |
| Place of Birth ________ City ________ Province/State ________ Country ________ | ||
| Citizen and Residence: ________ Country of Citizenship ________ Country of Permanent Residence ________ | ||