CCI Work and Travel Program Participant Terms and Conditions

1. GENERAL: I understand that Center for Cultural Interchange (CCI) is my J-1 Summer Work and Travel sponsor and that I accept decisions made by CCI in regards to all aspects of my program including visa sponsorship As a student sponsored by CCI, I understand that it is my responsibility to be aware of all rules and regulations (22 CFR part 62) in association with this visa: http://j1visa.state.gov/programs/summer-work-travel/ I understand that my sending agency (sending partner) may act on my behalf within my CCI online account. I agree to accept any actions my sending agent takes as though they were my own. 2. MY COMMITMENT TO CONTACT CCI: I understand that CCI must know how to contact me at any time, throughout the program duration as indicated on my DS-2019 form. I understand I need an individual, valid email address I agree to check my CCI online account (www.ccisevis.com) weekly, throughout my program duration, for important updates from CCI. I agree to use the CCI online system for all communication with CCI that is not an emergency. I agree to validate my program upon arrival to the U.S. and within 7 days of my DS2019 start date I agree to contact CCI within 24 hours: If I need any assistance or if my safety is in jeopardy, including hazard in the workplace If my housing address or the location of my work changes If the conditions of my employment are not being met Upon termination of employment I agree to contact CCI: To seek permission from CCI prior to quitting my job If I have any questions or concerns about my job or program I will contact CCI before contacting my sending partner or family In accordance with Department of State Monthly Monitoring provisions, at least once every month while participating on my program 3. SEVIS: I understand that I can check my SEVIS status at any time from within my CCI online account If my SEVIS status is not in good standing, it is my responsibility to cooperate with CCIs directives, including to return to my home country, if applicable 4. HEALTH AND SAFETY: I am aware of the details my health insurance policy, including all coverage, limitations, and exclusions I am responsible for all costs not covered by the insurance policy in place I understand that I must have insurance coverage the entire time I am in the U.S. I know that I can purchase additional insurance from CCI for my travel period I understand that I must buy motor vehicle insurance coverage applicable to the state where I am driving. I understand that the law of each state in the US is different in regard to requirements for motor vehicle insurance coverage. I agree that I cannot and will not operate a motor vehicle of any sort in the U.S. unless I obtain proof of the legally required insurance sufficient to satisfy all local legal requirements for said operation. I will not operate any motor vehicle after the use of any legal or illegal drugs which may impair the ability to operate a motor vehicle. I will not occupy any motor vehicle being operated by a person who has used any legal or illegal drugs which may impair the ability to operate a motor vehicle. 5. MONEY: I will bring a minimum of USD1000 to survive in the U.S. without a steady income for the first month of my program. I understand that I need to allow the first two (2) weeks of my program to adjust and be trained by my employer. I am responsible for any fees charged by the U.S. Department of State, or the SEVIS system, in regards to my program, even if invoiced for them by CCI I agree to all program-related fees charged by CCI, including additional fees incurred while on my program I agree that I will use my employers telephone only with a phone card. I must ask permission to use the phone, even when using a phone card. I agree to reimburse all outstanding debts incurred while on the program. Any medical bills will be paid and sent to the insurance company with my claim for reimbursement before I depart the U.S. I agree to continue to cooperate with insurers, medical providers and CCI if requested even after leaving the U.S. in order that proper reimbursement for medical expenses can be accomplished I acknowledge that certain tax deductions are required by the U.S. and State-specific laws. I understand that the net amount I will receive, after taxes, will be less than the gross amount my employer agreed to pay. 6. ACCLIMATING: I understand that there will be major differences between the lifestyle of my home country and the U.S. I understand that I must obey all national, state, and local laws at all times, as well as the rules of CCI, the employer and the host community. The breaking of any law or rule can result in dismissal from the program. I understand that I may smoke only in accordance with the rules of my workplace and housing I understand that the legal age to consume alcohol in the U.S. is 21 years old 7. MEDICAL AGREEMENT: I authorize CCI and its representatives to consent to any medical or dental treatment, rendered under the general supervision of medical staff, licensed under the provision of the Medicine and Dental Practice Acts. This authorization is given to provide authority and consent on my behalf. I authorize CCI to access any funds that I may have to be applied towards payment of any uninsured medical attention that I may have incurred I authorize CCI to access my medical information, should I be hospitalized for any reason 8. MISCELLANEOUS: I must arrive to the U.S. with a valid passport; visa; DS-2019 form; signed, CCI-approved job offer; I-94 immigration entry/exit card (supplied on airplane when arriving to the U.S.); and a roundtrip ticket to return to my home country at the end of the program I understand that the purpose of my J-1 Summer Work and Travel Program is cultural exchange and that program sponsorship is granted, in part, on the expectation that I will return to my home country upon completion of my program. Therefore, CCI will not take responsibility in aiding a change in visa, and will not take responsibility for participants who remain in the U.S. after the close of the program. It is the obligation of CCI to report any activities that are interpreted as being in defiance of visa or program regulations to the U.S. Departments of State and Homeland Security I understand that because I am a temporary worker, I am not eligible to receive paid vacation, sick or personal days from my employer. I understand that overtime compensation varies by state for temporary workers I may remain in the U.S. up to 30 days beyond my DS program end date, as long as I return to my home country in time for classes or am compliant with the U.S. Embassy date restrictions in my home country. I understand that I am responsible for all information provided in the mandatory Participant Virtual Orientation, which I agree to complete in my CCI online account prior to U.S. arrival I understand that CCI provides a cultural component to my WT program through the Greenheart Club. Information can be found in the Resources section of my CCI account I authorize CCI, its representatives, and its affiliates the irrevocable use of any photographs accompanying this application or any photographs/video taken while participating on a CCI program for promotion or publicity. I understand that I will not receive compensation for the use of my photograph(s)/video(s). I agree that CCI may use such photographs/videos of me with or without my name and for any lawful purpose, including, but not limited to such purposes as brochures, advertising, and website content. 9. LIABILITY RELEASE AGREEMENT: As a participant of the CCI program, I understand that circumstances may arise that are outside of CCIs control I renounce any claims against CCI and its representatives that may arise from circumstances outside of CCIs direct control I acknowledge that CCI cannot assure my personal security other than to vet the employer in the manner required by the Department of State I understand that it is my responsibility to inform CCI of any circumstances that may cause me harm or bring notoriety to CCI or the U.S. Department of State I agree to accept the final judgment of CCI for job assignments and decisions made by CCI in regards to my program I will not hold CCI responsible for any civil or criminal liability incurred by me while on my program This agreement and any claim related directly or indirectly to this agreement shall be governed and construed in accordance with the laws of the State of Illinois (without giving regard to the conflicts of law provisions thereof). No such claim shall be commenced, prosecuted or continued in any forum other than the courts of the State of Illinois and I submit on behalf of myself, my successors, assignees, and representatives, to the jurisdiction of such courts. I waive any and all right to argue that this choice of forum provision is or has become unreasonable; and any and all right to trial by jury in any action, proceeding or counterclaim related to or arising out of this agreement I affirm that the provisions of this agreement are severable and, in the event any term or condition hereof is found by a court of competent jurisdiction to be void or unenforceable, the remaining terms and conditions of this agreement shall, if permitted by law, remain in full force and effect. This agreement shall bind, and inure to the benefit of, the respective affiliates, relatives, heirs, trustees, and successors and assigns of the parties hereto.

RECOGNITION OF AGREEMENT: By submitting this form as part of my application, I confirm that I have read and agree to abide by the conditions above. There is no reason
(pre-existing health condition, emotional, or behavioral problems, etc.) why I should not be able to participate in the program. I confirm that I have not been convicted of any felony, and that falsifying or withholding of any information on the application could result in program dismissal. I agree to print this form and sign it in front of my sending organization.

Signature of Participant: Participant Name Printed:

Date:

CCI 746 North LaSalle Drive, Chicago, IL 60654 U.S.A. Tel: 866.684.9675 Fax: 312.944.2644 W: www.cci-exchange.org E: workprogram@cci-exchange.org Terms and Conditions (updated Nov 2, 2011)