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J-1 Orientation Acknowledgement Form

Please complete the following form:

AAG ID Number 
  
DS-2019 Number 
  
First Name 
  
Last Name   
E-mail address 
Country of citizenship   

Please check the boxes below:

I certify that I have received the following information:

  • A copy of the State Department Exchange Visitor Program Welcome Brochure. Click here
  • Alliance Abroad Group Handbook. Click here
  • Insurance information and contact numbers. Click here

I certify that I have received the AAG participant handbook, which contains the       following information:

  • The purpose of the J-1 Exchange Visitor Program
  • A description of the program in which you are participating
  • Rules that you are required to follow under the Alliance Abroad Group program
  • Address and telephone number of the Office of Exchange Coordination and Designation of the Department of State
  • Federal minimum wage requirements
  • How to get on-going support in the U.S. during my stay
  • Emergency contact information
  • Host Company information and accurate travel instructions and directions
  • Available health care, emergency assistance, and insurance coverage
  • Life and customs in the United States
  • How to deal with Culture Shock
  • Costs that you will likely incur (e.g., living expenses) while in the United States
  • Review of housing/meal plans (if applicable)
  • Challenges with accommodations (responsibility for damage)
  • Safety Issues
  • Local community resources (e.g., public transportation, libraries, recreation centers and banks)

I certify that I understand the following information:

  • I understand that I must follow all USA and State laws, all host company rules, and all rules set by Alliance Abroad Group.
  • I understand that I must stay at my assigned placement for the duration of the contract, and if I leave early, I must return to my home country right away at my own expense.
  • I understand that if I agree to housing arranged by my host company or others, I am contractually committed to stay in that housing for the duration of my program.
  • I understand that I am responsible for providing Alliance Abroad Group with my updated address within 7 calendar days of arrival by using the AAG website link. This information will be used to update my SEVIS status.
  • I understand that use of illegal drugs, drinking any time or place if I am under 21, being arrested or being fired from my job for criminal activity may result in the immediate termination from my program. If my program is recommended for termination, I must return home immediately or risk further involvement from the State Department or US authorities.
  • I understand that cultural information about my community (transportation, libraries and other useful information) can be found on the AAG website.


I'd like to request a copy of the participant handbook: Yes    No  


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