International J-1 Visa Registration Form r Asan international student you must register your} Visa within the frst week of your arrival in Washingcon, D.C, Please submic this Form and copis of al required documents on the date of che orientation sesion or within the first week of your arvval in Washington, a DG. Failure odo so: result in automatic cancelation of your Via you have any questions or concerns, please contac Luisa Solarte by phone 202-238-7950 or by email: uisasolarce@rweed, 1.0 _Intern/ Trainee Information in Washington, D.C. Tags mae oy ze 2.0 Internship Sice Information imerane Sha ow = 3.0 Intern/Trainee Checklist 3 Areyou goingto receive Stipend (stipend are not 34. Have you cncosed a copy of che Jl Visa stamp and/or scholarships)? D Yes O No Please indicate the amount per 3.2. Do you ceetify that you have a health insurance policy shat covers the requirements of the State Depastment as indicated on Page 7 of the precrval guide; and tha the policy is valid for che duration ofthe training/incernship rogram? Yes ONo 33. Do you acknowledge that you ate awate ofthe Home Country Presence Requirement (212) ofthe -1 Visa as stated on Page 8 of the pre-atrval guide? 35 36 37 38 Visa page? 0 Yes 0 No Have you enclosed acopy of the 1.94 document sccesed online? D Yes a No Have you enclosed a copy of your health insurance cad? D Yes 1D No Have you enclosed copy of your health insurance policy? 0 Yes 1D No Hive you enclosed copy of our return airplane vicket? Yes D No D Yes O No 39. Have you enclosed acopy of the DS-2019 Form? Yes No Signature Dale