INTERNATIONAL STUDENT

Pick up Date: ___________

J-1 Academic
Training
Authorization

Use this form to:

Request an academic training letter
Request a social security letter

Include with this completed form:

Unofficial Duckweb transcript
Current DS-2019
GTF Contract (If applicable)

DS-2019 Request Form

Letter from employer

Personal information
Family Name, First Name, Middle Name

Major

UO Student ID

To be completed by students academic advisor

1. Trainer Information

Company Name

Company Location

Name and address of training supervisor

Hours/Week

Training Start Date

Training End Date

2. This training is:

upon completion of study

upon completion of course requirements

during vacation period

part-time while engaged in studies

3. Goals and objectives of the specific training program ____________________________________________________________

____________________________________________________________________________________________________________
4. How does the training relate to the student's major field of study ___________________________________________________
____________________________________________________________________________________________________________
5. Why is the training an integral or critical part of the academic program of the Exchange Visitor student
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
As the student's Academic Advisor or Dean, I have presented the nature and details of the Academic Training program based on the
student's "offer of employment" letter. I approve of the amount of time requested as necessary to complete the goals and objectives of
the training. With this letter, I recommend that you authorize this student to participate in the Academic Training program.
Advisor or Dean Name: __________________________________ Title: ______________________________________

Signature: _____________________________________________ Date: _______________

For International Affairs use only

The academic training: is warranted
(22 CFR 62.23 (f))

is effective and appropriate

criteria and time limitations are satisfied

Advisor Name: __________________________Signature: _____________________________ Date: _______________

Office Use only: 1. In Status? Yes No _____Initial

2. Entered by? Initial_______ Date_______

333 Oregon Hall Phone (541) 346-3206 Fax (541) 346-1232

http://international.uoregon.edu intl@uoregon.edu