iceo

Program Budgeting (Please enter all amounts in US Dollars.)

ICEO USA Summer Work / Travel Program
Participant’s Application 2019

1. Program Income and Personal Funds:

____________
a. Personal Funds which you intend to bring with you to the United States: …….......…..……………………………………………........……. $ 1000
b. Wage: (number of hours per week x number of weeks x hourly wage) based on the information from your Employment
Confirmation Letter***: …..……..........……………………………………………………………………………….…………………………….………….......……. $ ____________
____________
Total Amount = $ 4840
2. Expenses connected with your participation in the ICEO Program:
____________
a. Total Program Fee paid to your recruitment agency in (country)_____________________________________:……………..…….. $ 1700
____________
b. Round trip air-ticket from your home country to the USA*: .……………………………………………….…………………………......………….. $ 900
____________
c. USA Consulate Fees: …………………………………………………………………………………………….……………………………………………….....….……. $ 160
____________
d. Total cost of accommodation in the United States during the program*: …………….….…………………………………………….....…….. $ 1200
____________
e. Total cost of basic household goods during the program**: ……………………………..…….……………………………….....………………….. $ 200
____________
f. Total cost of daily commute during the program*: …………………………………………….…….…………………………………………..…......….. $ 200
____________
g. Total cost of food during the program**: ………………………………………………………….…….……………………………………….....………….. $ 900
____________
h. Cost of other daily essentials during the program**: ………………………………………..…….……………………………………………....……… $ 150
____________
i. Cost of entertainment during the program**: …………………………………………………….…..…………………………………………….....……… $ 200
____________
j. Cost of participation in cultural activities*: ………………………………………………………….…..………………………………………….…….…..... $ 100
____________
k. Cost of other domestic transportation during the program**: ………………………….……..………………………………………….…...…….. $ 100
l. Cost of travel after the program*: …………………..……….……………………………………………...………………………………………….…....…..… $ ____________
____________
m. Emergency medical fund (insurance deductible): …..………....………………………………………..…………………………………………….…....…… $ 500

* Can be an approximate amount.

____________
Total Amount = $ 6310
** The ICEO Program Participant handbook can be used to estimate this value.
*** Information available for self-placed and ICEO placed participants only.

3. Anticipated financial balance at the end of the program (Total Amount from # 1 minus Total Amount from # 2.): ...... $ -1470
____________

Additional Information (If additional space is needed, please include answers on a seperate sheet of paper and attach to this application.)

1. How will you finance your participation in the ICEO Program? personal funds funds from parents/family bank loan
other ______________________________
2. Why do you want to take part in the ICEO Program?
Because I would like visit many places in the United State, meet new people,
________________________________________________________________________________________________________________
exchange culture and improve my English level.
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
3. What do you hope to achieve by participating in the ICEO Program?
________________________________________________________________________________________________________________
Meet more new places, in this time, I want to know New York City and Disneyland

________________________________________________________________________________________________________________
and I have made friends from different part of the world. Also improve my english level.

________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
4. Do you have any friends or relatives currently living in the United States? yes no
If yes; a) what is your relationship to this person(s) and; b) where are they living and for how many years?
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
5. Please provide a detailed description of how you intend to spend your time in the United States during the ICEO Program?
Visit many places of the city where I stay during the program, talk with the local people
________________________________________________________________________________________________________________
and know his culture and history
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________

International Cultural Exchange Organization Inc. / 11931 Foundation Place, Suite 220, Gold River, CA 95670 / Phone: (916) 985-4826 / Fax: (916) 985-9922 / www.iceoinc.org Page 3
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Additional Information - continued
ICEO USA Summer Work / Travel Program
Participant’s Application 2019

(If additional space is needed, please include answers on a seperate sheet of paper and attach to this application.)
6. Please provide a detailed description of your plans to participate in Cultural Activities during the ICEO Program (generic answers will not
be accepted).
________________________________________________________________________________________________________________
I´m planning to visit some theaters and museums, also know local people so get experiences and

________________________________________________________________________________________________________________
stories for future songs that you can compose.

________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
7. Please provide a detailed plan on how you are going to transfer from the Airport to your host company’s location after arrival to the
United States.
________________________________________________________________________________________________________________
ICEO SPONSOR WILL GIVE ME SUPPORT IN LOCAL TRANSPORTATION

________________________________________________________________________________________________________________
(HOW TO GO FROM THE AINPORT TO THE HOST COMPANY)

________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
8. Please provide a detailed plan on how you are going to identify and secure local daily transportation during your ICEO Program.
ICEO SPONSOR WILL PROVIDE ME THE INFORMATION ABOUT THE LOCAL
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
DAILY TRANSPORTATION
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
9. Please provide a detailed plan on how you are going to identify and secure housing during your ICEO Program (If housing is arranged by
your host company, please note “Housing arranged by host company” below; If housing is not arranged by your host company, please
answer the question that applies to you below).
a. If you have not yet identified and secured your housing, please provide detailed housing plans (generic answers will not be accepted).
_____________________________________________________________________________________________________________
ICEO SPONSOR WILL HELP ME IN HOW TO IDENTIFY AND SECURE HOUSIG

_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
b. If you already identified and secured your housing, please provide the following details.
i. How did you arrange this housing?
_____________________________________________________________________________________________________________
N/A

_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
ii. Housing information
Address of housing:
Security deposit (per participant / tenant): Type of housing:
Cost per week (per participant / tenant): Number of bedrooms:
Other fees: Number of tenants:
Furnishings / amenities included:
Specify utilities included and not included:
How are the above fees collected?
Will you be required to sign a lease or sublease? yes no
*If “yes”, please attach a copy of the lease or sublease agreement to be signed (if available).
**Please attach photos of housing: Exterior, Bedrooms, Common Area, Bathroom and Kitchen.

International Cultural Exchange Organization Inc. / 11931 Foundation Place, Suite 220, Gold River, CA 95670 / Phone: (916) 985-4826 / Fax: (916) 985-9922 / www.iceoinc.org Page 4
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Terms and Conditions
The following are the Terms and Conditions of participation in ICEO USA Summer Work / Travel Program. You are required to carefully read the following information, and
confirm that you have read, understood and agree to these terms by signing and dating the last page. If you fail to sign or date this section, ICEO will be unable to process
your application until you have done so.
Applicant/Participant Responsibilities
1. Each applicant agrees that all the information provided by participant
to ICEO, ICEO Partner or U.S. government as part of the application or as
necessary for participation in the ICEO USA Summer Work /Travel
Program (“Program”) is true to the best of his/her knowledge, and
acknowledges that any false or misleading information may lead to
immediate dismissal from the Program. The terms “applicant” and
“participant” are used throughout these terms and conditions to refer to
the person who has completed and submitted this application for
participation in the Program.
2. The applicant acknowledges the aims and objectives of the Program as
a U.S. Department of State authorized Exchange Visitor Program, with
the purpose of providing qualified individuals with cultural exchange
opportunities in the United States.
3. The applicant is responsible for considering his/her personal health
and safety needs when applying for or accepting a place in the Program.
If the applicant suffers from any health or other condition that would
create a risk for him/her while abroad, he/she should not apply.
4. The participant is responsible for reading and carefully considering all
materials made available to participant that relate to the term and
conditions of the Program; all U.S. government rules and regulations
regarding the Program; and all safety, health, legal, environmental,
political, cultural and religious customs and conditions in the U.S.. Each
participant will be responsible in the event that any term, condition, laws,
regulations, or customs are broken including, without limitation, these
Terms and Conditions, regardless of foreknowledge.
5. The applicant agrees to pay all fees in accordance with the
requirements of the ICEO in-country partner through whom he or she is
submitting an application (“ICEO Partner”).
6. The applicant is responsible for submitting all requested documenta-
tion (including passport) to the ICEO Partner in a timely fashion for visa
processing. ICEO cannot be held responsible for any additional costs
incurred (including the cost of rebooking a flight) by the applicant due to
delays in submitting documentation, verifying employment, or delays
caused by the U.S. Embassy in processing visa applications, scheduling a
visa interview, issuing a visa, or visa denial.
7. Applicant must pay the local visa fee to the U.S. Embassy. Applicant is
responsible for any additional visa fees that might apply at the U.S.
Embassy or Consulate in the country where he/she is applying for the
visa, as well as the U.S. Government SEVIS fee collected as part of the
application.
8. Applicant must attend an interview with an ICEO representative and/or
ICEO either in-person or by video-conference and complete language
screening in order to participate in the Program.
9. Participant is required to attend an ICEO orientation prior to leaving
his/her home country.
10. It is the responsibility of the participant to exercise due care once in
possession of the legal documentation (DS- 2019, Passport and Visa). The
cost of replacing these items will be the responsibility of the participant.
In addition, the participant is responsible for providing to ICEO all
information necessary for ICEO to activate participant’s Program status in
SEVIS. All costs associated with any Program reinstatements will be
borne by the participant.
11. Participant is responsible for all the costs associated with processing
and shipping Travel Request Forms.
12. Participant must supply ICEO with the name and contact details of
next of kin, to be contacted in the case of emergency. These details must
be included on the application form and be kept current during the
Program.
13. Participant is responsible for all of his / her acts along with any loss or
damage resulting there from while on the Program. The participant
agrees to indemnify and hold harmless ICEO for any claim, liability or loss
arising from, related to or resulting from directly or indirectly
participant’s conduct.
14. All travel before, during and after the Program is at the participant’s
own cost and risk. Any participant who chooses to operate a motorized
vehicle is responsible for obtaining the necessary license, permission and
insurance and does so at his/her own risk.
15. If during the course of the Program the participant encounters any
difficulties with any element of the Program such as issues concerning
safety, health, employment, housing (including charges or fees for
housing) sanitary conditions, over crowding, or any other problem, the
participant should notify ICEO as soon as possible by phoning ICEO at 1-
916-985-4826 during business hours or in an emergency at 1-877-423-
6462, 24 hours a day, 7 days a week.
16. A schedule of monthly meetings between participant and an ICEO
representative will be provided to participant prior to participant’s
departure to the U.S. The monthly meetings will be conducted in-person,
by telephone, or via electronic mail at ICEO’s direction. The monthly
meetings are mandatory and missing monthly meetings will lead to
participant’s termination from the Program. Participant must notify ICEO
of any issues affecting participant’s health, safety, or welfare during this
monthly contact. Once a month, participant must also complete Monthly
Activity Report available on line at www.iceoinc.org. Participant agrees to
respond in a timely manner to any ICEO communication requiring a
response.
ICEO USA Summer Work / Travel Program
Participant’s Application 2019
conditions of such employment and fully vetted the U.S. employer as
17. Participant is required to comply with all U.S. Government visa and
immigration requirements, including SEVIS compliance as follows: a) required by Summer Work Travel program regulations. Programs of
Notification to ICEO of arrival to the United States within 10 days of the participants who begin employment prior to (i) the approval by ICEO of
arrival but no later than 20 days from the Program start date listed on the the U.S. employers, or (ii) the approval by ICEO of the position with an
participant’s DS-2019 Form and confirmation of his / her U.S. residence approved U.S. employer will be immediately terminated by ICEO.
address; b) Notification to ICEO of any change in U.S. residence address 24. Participant is required to maintain communication with ICEO and
within 10 days of the change; c) Providing ICEO with a valid e-mail his/her U.S. employer prior to arrival, notify ICEO and U.S. employer in
address and phone number upon arrival to the United States; d) advance of his/her arrival and departure dates, and advise ICEO and U.S.
Notification to ICEO of any change in phone number or e-mail address employer of any changes to his/her travel itinerary due to visa delays or
within 10 days after the change. ICEO will terminate participant’s any unforeseen circumstances.
Program if he/she fails to comply with any of the above Program 25. Under no circumstances are job positions guaranteed including,
notification requirements. without limitation, any job with an ICEO-arranged U.S. employer. Even in
18. Participant must have at least $800.00 upon arrival in the U.S. in order the case when an employer represents that a job is being held, this does
to support himself/herself in the U.S. until receiving his/her first not constitute a binding contract that the job will be available when the
paycheck. However, a participant who is a national of a Visa Waiver participant arrives. The employer’s commitment is one of good faith
Program country and who has not secured a job prior to arriving in the only. In addition, if the participant is not fluent in English and/or does
U.S. must have at least $1500.00 upon arrival in the U.S. not arrive on time and/or has misrepresented any statement in the
19. Participant is solely responsible for his/her own conduct and well- application, participant may be terminated from the Program or the
being both on and off the job. ICEO cannot and does not monitor the positions may be revoked by the U.S. employer. In addition, if the
participant’s personal conduct, except to the limited extent indicated in participant does not meet the contractual obligations with the employer
this Terms and Conditions. Participant must follow all U.S. Federal, state or with ICEO under any agreement between such party and participant,
and local laws, rules, statutes, ordinances and regulations (“Laws”) and ICEO, at its sole discretion, may terminate the participant’s participation
may be subject to financial penalties, deportation and/or incarceration as in the Program.
a result of not following such Laws. 26. ICEO is not responsible for any participant expenses including,
without limitation, any expenses incurred if for any reason the
Employment or Job Related Conditions participant has not started work with the U.S. employer by the agreed
date for any reason at his/her place of employment and/or the work
20. Regardless of who arranges the employment placement, participant
hours are limited or unavailable.
can only be placed in employment positions which require, at minimum,
27. Once a participant accepts a position with a U.S. employer,
no more than minimal training, are seasonal or temporary in nature,
participant agrees to stay at that place of employment for the duration
provide opportunities for regular communication and interaction with
of the Program. If participant wishes to leave the position after
U.S. citizens, allow participant to experience U.S. culture and not displace
participant starts work or declines to start work after accepting a
year-round U.S. workers. ICEO reserves the right to deny any
position, participant must immediately notify ICEO in writing and must
employment placement according to the current and/or anticipated
obtain ICEO’s written permission prior to leaving the U.S. employer. If
rules, regulations, and intent of the J-1 Exchange Visitor program.
participant does not receive prior written approval to change positions
Relevant factors include, but are not limited to, the job duties, workplace,
from ICEO, and if participant leaves this employment without the prior
geographical location, work schedule, and hours per week and any other
written approval of ICEO, ICEO reserves the right to immediately revoke
factor at ICEO’s discretion.
sponsorship of participant’s Program.
21. Regardless of who arranges the employment placement, ICEO cannot
28. No person or entity other than ICEO, ICEO Partner or participant is
accept applications from participants for, and participants are prohibited
allowed to arrange for an employment position for participant as the
from working in, any of the following positions in the U.S.:
part of the Program.
(a) In positions that could bring notoriety or disrepute to the Exchange
29. For those employment positions arranged by ICEO with U.S.
Visitor Program as determined by ICEO;
employers, if the position is not available, through no fault of
(b) In sales positions that require participants to purchase inventory that
participant, ICEO will assist the participant in finding another position
they must sell in order to support themselves;
with a U.S. employer. However, ICEO makes no guarantee that it will be
(c) In domestic help positions in private homes (e.g., child care, elder
able to secure another position for participant. If a new position is
care, gardener, chauffeur);
available, it is likely the position would not be in the same geographical
(d) As pedicab or rolling chair drivers or operators;
area or of the same type of work the participant had previously or
(e) As operators or drivers of vehicles or vessels for which drivers’ licenses
prefers.
are required regardless of whether they carry passengers or not;
30. For those employment positions not-arranged by ICEO with U.S.
(f) In positions related to clinical care that involves patient contact;
employers, if the position is not available, through no fault of
(g) In any position in the adult entertainment industry (including, but not
participant, it is participant’s responsibility to identify another
limited to, jobs with escort services, adult book/video stores, and strip
employment position. However, in such situations, ICEO will offer
clubs);
reasonable assistance to participant in their effort to identify another
(h) In positions requiring work hours that fall predominantly between
position. ICEO cannot guarantee that a new position will be available.
10:00 p.m. and 6:00 a.m.;
31. In case of change of job or of premature termination of job, or if the
(i) In positions declared hazardous to youth by the Secretary of Labor at
employment is terminated before the end of the Program for any
Subpart E of 29 CFR part 570;
reason, or if the participant decides to return home early, no fees will be
(j) In positions that require sustained physical contact with other people
refunded.
and/or adherence to the Centers for Disease Control and Prevention’s
32. If a participant is fired from his or her job for violation of a Law or
Universal Blood and Body Fluid Precautions guidelines (e.g., body
violation of U.S. employer policies or procedures, including failing a U.S.
piercing, tattooing, massage, manicure);
employer required drug test at the commencement or anytime during
(k) In positions that are substantially commission-based and thus do not
employment, or if participant violates any ICEO agreement, rule or
guarantee that participants will be paid minimum wage in accordance
policy, participant will be terminated from the Program and no fees will
with federal and state standards;
be refunded.
(l) In positions involved in gaming and gambling that include direct
33. If participant’s job ends before the end date on the DS-2019 Form
participation in wagering and/or betting;
(Program end date) for any reason other than disciplinary actions by U.S
(m) In positions in chemical pest control, warehousing, catalogue/online
employer or ICEO but including if the participant voluntarily stops work,
order distribution centers;
participant must inform ICEO immediately. In such an event the
(n) In positions with travelling fairs or itinerant concessionaires;
following options are available to participant:
(o) In positions for which there is another specific J visa category (e.g.,
A) If participant decides to identify a new U.S. employer for the
camp counselor, intern, trainee);
remainder of the Program, the new U.S. employer must be approved by
(p) In positions in the North American Industry Classification System’s
ICEO prior to participant beginning work for the new U.S. employer as
(NAICS) Goods-Producing Industries occupational categories industry
described in point 23 of this Terms and Conditions. Participant must
sectors 11, 21, 23, 31–33 numbers (set forth at
identify new U.S. employer and ICEO must be able to approve both the
http://www.bls.gov/iag/tgs/iag_index_naics.htm).
new U.S. employer and the offered employment position within 21 days
(q) In positions in a staffing agency;
from the last date of employment with the previous U.S. employer. If
(r) In positions that require participant to obtain or hold a specialized
participant fails to identify a new U.S. employer or ICEO is unable to
license; or
approve the identified new U.S. employer or offered employment
(s) In any other position ICEO deems inappropriate.
position within the allotted 21 days, ICEO will complete participant’s
A complete list of prohibited employment positions is available from ICEO
Program at the end of the allotted 21 days, if applicable. In addition,
upon request.
within 72 hours from the last date of employment with the previous U.S.
22. Participant must work for the employer listed on their DS-2019 Form.
employer, participant must provide ICEO with proof of sufficient
If, for any reason, a change of employer becomes necessary, participant
financial resources to support himself/herself during the search for
must contact ICEO and get written approval BEFORE changing employers.
employment. If participant is unable to provide proof of sufficient funds
23. Participant may not begin working at initial, replacement or
within the allotted 72 hours, ICEO will complete participant’s Program at
additional jobs with a U.S. employer until ICEO has verified the terms and
the end of the allotted 72 hours.