Professional Documents
Culture Documents
Training Plan - RUPESH KUMAR SINHA-418
Training Plan - RUPESH KUMAR SINHA-418
Training Plan - RUPESH KUMAR SINHA-418
1405-0170
U.S. Department of State EXPIRATION DATE: 03-31-2018
ESTIMATED BURDEN: 1.5 hours
TRAINING/INTERNSHIP PLACEMENT PLAN
SECTION 1: ADDITIONAL EXCHANGE VISITOR INFORMATION
Trainee/Intern Name (Surname/Primary, Given Name(s) (must match passport name) E-mail Address
SECTION 2: COMPENSATION
Organization Name Address Suite
SECTION 3: CERTIFICATIONS
Trainee/Intern - I certify that:
1. I have reviewed, understand, and will follow this Training/Internship Placement Plan (T/IPP);
I am entering into this Exchange Visitor Program in order to participate as a Trainee or Intern as delineated in this T/IPP and not simply to
2. engage in labor or work within the United States.
I understand that the intent of the Exchange Visitor Program is to allow me to enhance my skills and gain exposure to U.S. culture and business
3.
in a way that will be useful to me when I return home upon completion of my program.
I understand that my internship/training will take place only at the organization listed on this T/IPP and that working at another organization while
4.
on the Exchange Visitor Program is prohibited.
5. I will contact the Sponsor at the earliest available opportunity regarding any concerns, changes in, or deviations from this T/IPP.
6. I will respond in a timely way to all inquiries and monitoring activities of my sponsor.
8. I will contact the U.S. Department of State's Bureau of Educational and Cultural Affairs (ECA) at the earliest possible opportunity if I believe that
my sponsor or supervisor (as set forth on page 3, section 4), is not providing me with a legitimate internship or training, as delineated on my
T/IPP; and
9. I declare and affirm under penalty of perjury that the statements and information made herein are true and correct to the best of my knowledge,
information and belief. The law provides severe penalties for knowingly and willfully falsifying or concealing a material fact, or using any false
document in the submission of this form.
Signature of Trainee/Intern
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03-2015
Document Ref: RVDBF-KJ5EX-XXPO5-XECHJ Page 1 of 14
Sponsor-
1. I have reviewed, understand, and will ensure that the Supervisor (as set forth on page 3, section 4) follows this Training/Internship Placement
Plan (T/IPP) regarding the Trainee or Intern listed above;
2. I will notify the designated U.S. Department of State's Bureau of Educational and Cultural Affairs (ECA) at the earliest available opportunity
regarding any concerns about, changes in, or deviations from this Training/Internship Placement Plan (T/IPP), including, but not limited to,
changes of Supervisor or host organization;
3. I will adhere to all applicable regulatory provisions that govern this program (see 22 CFR Part 62), including, but are not limited to, the following:
a. I will ensure that the Trainee or Intern named in this T/IPP receives continuous on-site supervision and mentoring by experienced and
knowledgeable staff;
b. I have confirmed with the Supervisor or host organization representative that sufficient resources, plant, equipment, and trained personnel will
be available to provide the specified training or internship program set forth in this T/IPP;
c. I will ensure that the Trainee or Intern named in this T/IPP obtains skills, knowledge, and competencies through structured and guided
activities such as classroom training, seminars, rotation through several departments, on-the-job training, attendance at conferences, and
similar learning activities, as appropriate in specific circumstances;
d. I will ensure that the Trainee or Intern named in this T/IPP does not displace full-or part-time temporary or permanent American workers or
serve to fill a labor needed and ensure that the position that the Trainee or Intern fills exists primarily to assist the Trainee or Intern in achieving
the objectives of his or her participation in this training or internship program;
e. I certify that this training or internship meets all of the requirements of the Fair Labor Standards Act, as amended (29 U.S.C. 201 et seq.). I
also certify that training or internships in the field of agriculture meet all requirements of the Migrant and Seasonal Worker Protection Act, as
amended (29 U.S.C. 1801 et seq.)
f. I will notify the Department of State if I receive information regarding a serious problem or controversy involving the Trainee or Intern named in
this T/IPP that could be expected to bring the Department of State, the Exchange Visitor Program, or the Sponsor's exchange visitor program
into notoriety or disrepute; and
g. I declare and affirm under penalty of perjury that the statements and information made herein are true and correct to the best of my knowledge,
information and belief. The law provides severe penalties for knowingly and willfully falsifying or concealing a material fact, or using any false
document in the submission of this form.
DS-7002 Page 2 of 4
03-2015
Juliana.Baptista@fourseasons.com 215-419-5000
Description of Trainee/Intern's role for this program or phase
Rupesh will receive a comprehensive introduction to our management team and the new Host Organization. This orientation aims to familiarize Rupesh with the
Host Organization's mission, vision, systems, networks, and essential rules and regulations. Our goal is to ensure he seamless integration into the environment by
providing a thorough understanding of the area, location, as well as the pertinent policies and procedures.
Please list the names and titles of those who will provide continuous (for example, daily) supervision of the Trainee/Intern, including the primary
supervisor. What are these persons' qualifications to teach the planned learning?
Rupesh will receive direct supervision from the primary supervisor, Juliana Baptista, the Talent Acquisition Specialist and main supervisor with more than 9 years
of experience in the field.
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02-2018
Document Ref: RVDBF-KJ5EX-XXPO5-XECHJ Page 3 of 14
What plans are in place for the Trainee/Intern to participate in cultural activities while in the United States?
Rupesh will be assisted in becoming acquainted with the area help all interns discover the city. The public transportation system will be explained to Rupesh. He
will get introduced to American culture and will spend time on a daily basis with American employees and get to know their teammates.
How specifically will these knowledge, skills, or techniques be taught? Include specific tasks and activities (Interns) and/ or methodology of training
and chronology/syllabus (Trainees).
The supervisor will provide an orientation checklist, and a new comers manual to help Rupesh understand the Host Organization's culture. Activities such as
leader's presentations explaining organizational culture, quizzes, ice breakers activities will take place. Rupesh will get verbal coaching, personal counseling,
shadowing, and actual on the job training in order to get up and running with the Culinary operations as soon as possible.
How will the Trainee/Intern's acquisition of new skills and competencies be measured?
Weekly feedback considering performance will provide insight to Rupesh 's evolution. The supervisor will observe Rupesh during completion of
tasks and will provide verbal feedback throughout the shift. Only when having completed the goals for this phase, can Rupesh move on to the next
one. The final overall performance evaluation will measure the amount Rupesh has learned and highlight the newly acquired skills and
competencies.
DS-7002 Page 4 of 5
02-2018
Document Ref: RVDBF-KJ5EX-XXPO5-XECHJ Page 4 of 14
Phase Supervisor - I certify that:
1. I have reviewed, understand, and will follow this Training/Internship Placement Plan (T/IPP);
2. I will contact the Sponsor at the earliest possible opportunity if I believe that the Trainee or Intern is not receiving the type of training delineated on
this T/IPP;
3. I will actively support the Sponsor by adhering to all applicable regulatory provisions that govern this program (see 22 CFR Part 62);
4. The Trainee or Intern named in this T/IPP will not displace full-or part-time, seasonal or permanent American workers, or serve to fill a labor need;
5. I will conduct the required periodic evaluations of the Trainee or Intern named in this T/IPP;
6. I will notify the designated Sponsor contact at the earliest available opportunity regarding any concerns about, changes in, or deviations from this
T/IPP.
7. I will notify the Sponsor in the event of an emergency involving the Trainee or Intern named in this T/IPP, as well as any information that I receive
about the Trainee or Intern that might have an effect on that exchange visitor's health, safety, or welfare;
8. I will notify the Sponsor if I receive information regarding a serious problem or controversy involving the Trainee or Intern named in this T/IPP that
could be expected to bring the Department of State, the Exchange Visitor Program, or the Sponsor's exchange visitor program into notoriety or
disrepute;
9. I am participating in this Exchange Visitor Program in order to provide the Trainee or Intern named in this T/IPP with training or an internship as
delineated in this T/IPP;
10. I certify that this training or internship meets all the requirements of the Fair Labor Standards Act, as amended (29 U.S.C. 201 et seq.) I also
certify that training or internships in the field of agriculture meet all requirements of the Migrant and Seasonal Worker Protection Act, as amended
(29 U.S.C. 1801 et seq.).
11. I declare and affirm under penalty of perjury that the statements and information made herein are true and correct to the best of my knowledge,
information and belief. The law provides severe penalties for knowingly and willfully falsifying or concealing a material fact, or using any false
document in the submission of this form.
Signature of Supervisor
PURPOSE: The information solicited on this form will be used to provide clarity of training and intern programs offered by entities designated by the
U.S. Department of State to conduct exchange visitor programs; for general statistical use; and to administer the Trainee and Intern categories of the
Exchange Visitor Program.
ROUTINE USES: The information on this form may be shared with entities administering the program on behalf of the Department; federal, state,
local, or foreign government entities for law enforcement purposes; to members of Congress in response to a request on your behalf . More
information on the Routine Uses for the system can be found in the System of Records Notice State-08, Educational and Cultural Exchange Program
Records.
DISCLOSURE: Participation in this program is voluntary; however, failure to provide the information may delay or prevent participation in the
Exchange Visitor Program.
PAPER WORK REDUCTION ACT
Public reporting burden for this collection of information is estimated to average 2 hours per response, including time required for searching existing
data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection. You do
not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy of this
burden estimate and/or recommendations for reducing it, please send them to: ECA/EC, SA-4, U.S. Department of State, Washington, DC 20522.
DS-7002 Page 5 of 5
02-2018
ryan.schmitt@fourseasons.com 215-419-5000
Description of Trainee/Intern's role for this program or phase
Following the completion of Orientation, Rupesh will have the opportunity to continue training in Garde Manger or the Cold Kitchen. Knowledge of this kitchen is
essential for a culinary career as it promotes direct relationships with key staff in the kitchen, stewarding, purchasing and storeroom areas. Rupesh will learn and
improve the knowledge and skills related to the ability to prioritize, organize and follow through, perform well under pressure of meeting production schedules and
timelines for guests' cold food orders, transport cases of received goods to assigned kitchen stations and pots and pans of food from storage/prep areas to the serving
line and ability to use all senses to ensure quality standards are met.
Please list the names and titles of those who will provide continuous (for example, daily) supervision of the Trainee/Intern, including the primary
supervisor. What are these persons' qualifications to teach the planned learning?
Rupesh will receive direct supervision from Ryan Schmitt , phase supervisor and Executive sous Chef, who has more than 20 years experience in the field
DS-7002 Page 3 of 5
02-2018
Document Ref: RVDBF-KJ5EX-XXPO5-XECHJ Page 6 of 14
What plans are in place for the Trainee/Intern to participate in cultural activities while in the United States?
During this phase,Rupesh will have the opportunity to visit Philadelphia Museum of Art- the various classes of artwork include sculpture, paintings, prints,
drawings, photographs, armor, and decorative arts.The Philadelphia Museum of Art administers several annexes including the Rodin Museum, also located on the
Benjamin Franklin Parkway, and the Ruth and Raymond G. Perelman Building, which is located across the street just north of the main building. National and
local festivities might be celebrated: Halloween, Thanksgivings, Christmas, New Year's.
How specifically will these knowledge, skills, or techniques be taught? Include specific tasks and activities (Interns) and/ or methodology of training
and chronology/syllabus (Trainees).
Rupesh will shadow and observe a team member perform the following tasks:
- Maintain and strictly abide by states sanitation/health regulations and requirements
- Monitor the quality of specified products received from suppliers and ensure compliance with Restaurant standards
- Start prep tasks and production of items needed for the day
- Select, clean, and prepare fruits and vegetables
- Produce salads, fruit/vegetable/cheese/meat mirrors, trays and center pieces
- Maintain proper storage procedures
- Prepare and produce cold menu items
- Collaborate with Kitchen Staff wherever required to ensure optimum service
How will the Trainee/Intern's acquisition of new skills and competencies be measured?
Monthly feedback considering performance will provide insight to Rupesh 's evolution. The supervisor will observe Rupesh during completion of
tasks and will provide verbal feedback throughout the rotation. Only when having completed the goals for this phase can Rupesh move on to the
next one. The final overall performance evaluation will measure the amount Rupesh has learned and highlight the newly acquired skills and
competencies
DS-7002 Page 4 of 5
02-2018
Document Ref: RVDBF-KJ5EX-XXPO5-XECHJ Page 7 of 14
Phase Supervisor - I certify that:
1. I have reviewed, understand, and will follow this Training/Internship Placement Plan (T/IPP);
2. I will contact the Sponsor at the earliest possible opportunity if I believe that the Trainee or Intern is not receiving the type of training delineated on
this T/IPP;
3. I will actively support the Sponsor by adhering to all applicable regulatory provisions that govern this program (see 22 CFR Part 62);
4. The Trainee or Intern named in this T/IPP will not displace full-or part-time, seasonal or permanent American workers, or serve to fill a labor need;
5. I will conduct the required periodic evaluations of the Trainee or Intern named in this T/IPP;
6. I will notify the designated Sponsor contact at the earliest available opportunity regarding any concerns about, changes in, or deviations from this
T/IPP.
7. I will notify the Sponsor in the event of an emergency involving the Trainee or Intern named in this T/IPP, as well as any information that I receive
about the Trainee or Intern that might have an effect on that exchange visitor's health, safety, or welfare;
8. I will notify the Sponsor if I receive information regarding a serious problem or controversy involving the Trainee or Intern named in this T/IPP that
could be expected to bring the Department of State, the Exchange Visitor Program, or the Sponsor's exchange visitor program into notoriety or
disrepute;
9. I am participating in this Exchange Visitor Program in order to provide the Trainee or Intern named in this T/IPP with training or an internship as
delineated in this T/IPP;
10. I certify that this training or internship meets all the requirements of the Fair Labor Standards Act, as amended (29 U.S.C. 201 et seq.) I also
certify that training or internships in the field of agriculture meet all requirements of the Migrant and Seasonal Worker Protection Act, as amended
(29 U.S.C. 1801 et seq.).
11. I declare and affirm under penalty of perjury that the statements and information made herein are true and correct to the best of my knowledge,
information and belief. The law provides severe penalties for knowingly and willfully falsifying or concealing a material fact, or using any false
document in the submission of this form.
Signature of Supervisor
PURPOSE: The information solicited on this form will be used to provide clarity of training and intern programs offered by entities designated by the
U.S. Department of State to conduct exchange visitor programs; for general statistical use; and to administer the Trainee and Intern categories of the
Exchange Visitor Program.
ROUTINE USES: The information on this form may be shared with entities administering the program on behalf of the Department; federal, state,
local, or foreign government entities for law enforcement purposes; to members of Congress in response to a request on your behalf . More
information on the Routine Uses for the system can be found in the System of Records Notice State-08, Educational and Cultural Exchange Program
Records.
DISCLOSURE: Participation in this program is voluntary; however, failure to provide the information may delay or prevent participation in the
Exchange Visitor Program.
PAPER WORK REDUCTION ACT
Public reporting burden for this collection of information is estimated to average 2 hours per response, including time required for searching existing
data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection. You do
not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy of this
burden estimate and/or recommendations for reducing it, please send them to: ECA/EC, SA-4, U.S. Department of State, Washington, DC 20522.
DS-7002 Page 5 of 5
02-2018
ryan.schmitt@fourseasons.com 215-419-5000
Description of Trainee/Intern's role for this program or phase
Rupesh will receive training in Hospitality and Tourism with an emphasis in Culinary Arts. Rupesh will learn the procedures and regulations for service standards
and gain an overview of all operations in the meat sector of the kitchen.
Please list the names and titles of those who will provide continuous (for example, daily) supervision of the Trainee/Intern, including the primary
supervisor. What are these persons' qualifications to teach the planned learning?
Rupesh will receive direct supervision from Ryan Schmitt, phase supervisor and Executive sous Chef, who has more than 20 years experience in the field.
DS-7002 Page 3 of 5
02-2018
Document Ref: RVDBF-KJ5EX-XXPO5-XECHJ Page 9 of 14
What plans are in place for the Trainee/Intern to participate in cultural activities while in the United States?
In this phase, Rupesh can visit the Liberty Bell, previously called the State House Bell or Old State House Bell, is an iconic symbol of American independence,
located in Philadelphia, Pennsylvania. He can also visit the Franklin Institute- a science museum and the center of science education and research in Philadelphia,
Pennsylvania. It is named after the American scientist and statesman Benjamin Franklin. It houses the Benjamin Franklin National Memorial.National and local
festivities might be celebrated: Valentine's Day, St Patrick's Day.
How specifically will these knowledge, skills, or techniques be taught? Include specific tasks and activities (Interns) and/ or methodology of training
and chronology/syllabus (Trainees).
There will be a comprehensive training in butchering which is an important area for any manager and staff to know in a restaurant business. Rupesh will have one
to one butchering sessions with a supervisor and assist the Executive Chef's daily tasks and activities. During this phase, Rupesh will focus on learning all the
policies, service essentials standards, standard operating manual, disciplinary actions. Rupesh will learn butchering procedures and techniques, demonstration
sessions will be organized as well as and one to one trainings with a direct supervisor. Rupesh will be trained in detail on butchering beef poultry. Training will
include usable trim and wastage trim, as well as how to prevent cross contamination. Rupesh will also assist with fill protein requisitions for outlets
How will the Trainee/Intern's acquisition of new skills and competencies be measured?
There will be a comprehensive training in butchering which is an important area for any manager and staff to know in a restaurant business.
Rupesh will have one to one butchering sessions with a supervisor and assist the Executive Chef's daily tasks and activities. During this phase,
Rupesh will focus on learning all the policies, service essentials standards, standard operating manual, disciplinary actions. Rupesh will learn
butchering procedures and techniques, demonstration
sessions will be organized as well as and one to one trainings with a direct supervisor. Rupesh will be trained in detail on butchering beef poultry.
Training will include usable trim and wastage trim, as well as how to prevent cross contamination. Rupesh will also assist with fill protein
requisitions for outlets
DS-7002 Page 4 of 5
02-2018
Document Ref: RVDBF-KJ5EX-XXPO5-XECHJ Page 10 of 14
Phase Supervisor - I certify that:
1. I have reviewed, understand, and will follow this Training/Internship Placement Plan (T/IPP);
2. I will contact the Sponsor at the earliest possible opportunity if I believe that the Trainee or Intern is not receiving the type of training delineated on
this T/IPP;
3. I will actively support the Sponsor by adhering to all applicable regulatory provisions that govern this program (see 22 CFR Part 62);
4. The Trainee or Intern named in this T/IPP will not displace full-or part-time, seasonal or permanent American workers, or serve to fill a labor need;
5. I will conduct the required periodic evaluations of the Trainee or Intern named in this T/IPP;
6. I will notify the designated Sponsor contact at the earliest available opportunity regarding any concerns about, changes in, or deviations from this
T/IPP.
7. I will notify the Sponsor in the event of an emergency involving the Trainee or Intern named in this T/IPP, as well as any information that I receive
about the Trainee or Intern that might have an effect on that exchange visitor's health, safety, or welfare;
8. I will notify the Sponsor if I receive information regarding a serious problem or controversy involving the Trainee or Intern named in this T/IPP that
could be expected to bring the Department of State, the Exchange Visitor Program, or the Sponsor's exchange visitor program into notoriety or
disrepute;
9. I am participating in this Exchange Visitor Program in order to provide the Trainee or Intern named in this T/IPP with training or an internship as
delineated in this T/IPP;
10. I certify that this training or internship meets all the requirements of the Fair Labor Standards Act, as amended (29 U.S.C. 201 et seq.) I also
certify that training or internships in the field of agriculture meet all requirements of the Migrant and Seasonal Worker Protection Act, as amended
(29 U.S.C. 1801 et seq.).
11. I declare and affirm under penalty of perjury that the statements and information made herein are true and correct to the best of my knowledge,
information and belief. The law provides severe penalties for knowingly and willfully falsifying or concealing a material fact, or using any false
document in the submission of this form.
Signature of Supervisor
PURPOSE: The information solicited on this form will be used to provide clarity of training and intern programs offered by entities designated by the
U.S. Department of State to conduct exchange visitor programs; for general statistical use; and to administer the Trainee and Intern categories of the
Exchange Visitor Program.
ROUTINE USES: The information on this form may be shared with entities administering the program on behalf of the Department; federal, state,
local, or foreign government entities for law enforcement purposes; to members of Congress in response to a request on your behalf . More
information on the Routine Uses for the system can be found in the System of Records Notice State-08, Educational and Cultural Exchange Program
Records.
DISCLOSURE: Participation in this program is voluntary; however, failure to provide the information may delay or prevent participation in the
Exchange Visitor Program.
PAPER WORK REDUCTION ACT
Public reporting burden for this collection of information is estimated to average 2 hours per response, including time required for searching existing
data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection. You do
not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy of this
burden estimate and/or recommendations for reducing it, please send them to: ECA/EC, SA-4, U.S. Department of State, Washington, DC 20522.
DS-7002 Page 5 of 5
02-2018
ryan.schmitt@fourseasons.com 215-419-5000
Description of Trainee/Intern's role for this program or phase
Rupesh will receive training in Hospitality and Tourism with an emphasis in Culinary Arts. Rupesh will be exposed to training within the field of Culinary Arts, and
more specifically in the Fish and Saucier section of the kitchen throughout this phase.
Please list the names and titles of those who will provide continuous (for example, daily) supervision of the Trainee/Intern, including the primary
supervisor. What are these persons' qualifications to teach the planned learning?
Rupesh will receive direct supervision from, Ryan Schmitt phase supervisor and Executive Sous Chef, who has more than 20 years experience in the field.
DS-7002 Page 3 of 5
02-2018
Document Ref: RVDBF-KJ5EX-XXPO5-XECHJ Page 12 of 14
What plans are in place for the Trainee/Intern to participate in cultural activities while in the United States?
During this phase, Rupesh will have the opportunity to hangout in the historic hub for eclectic foods and goods- Reading Terminal Market. He can also visit Betsy
Ross House- a landmark in Philadelphia purported to be the site where the seamstress and flag-maker Betsy Ross lived when she is said to have sewed the first
American Flag. Rupesh might celebrate local festivities: Memorial Day, 4th of July celebration.
How specifically will these knowledge, skills, or techniques be taught? Include specific tasks and activities (Interns) and/ or methodology of training
and chronology/syllabus (Trainees).
During this phase, Rupesh will learn the Saucier Department's procedures, operations, essential activities and tasks. Rupesh will be introduced to the manuals that
will help Rupesh learn the methods and techniques needed as well as recipes. Rupesh will learn methods and procedures for sauces, stocks, portion control and
portion planning by having one to one sessions with a supervisor. Rupesh will learn food cost and develop managerial skills by interacting with other
departments and managing cost optimization.
How will the Trainee/Intern's acquisition of new skills and competencies be measured?
Monthly feedback considering performance will provide insight to Rupesh's evolution. Supervisor will observe Rupesh during completion of tasks
and will provide verbal feedback throughout the shift. Only when having completed the goals for this phase, can Rupesh move on to the next one.
The final overall performance evaluation will measure the amount Rupesh has learned and highlight the newly acquired skills and competencies
DS-7002 Page 4 of 5
02-2018
Document Ref: RVDBF-KJ5EX-XXPO5-XECHJ Page 13 of 14
Phase Supervisor - I certify that:
1. I have reviewed, understand, and will follow this Training/Internship Placement Plan (T/IPP);
2. I will contact the Sponsor at the earliest possible opportunity if I believe that the Trainee or Intern is not receiving the type of training delineated on
this T/IPP;
3. I will actively support the Sponsor by adhering to all applicable regulatory provisions that govern this program (see 22 CFR Part 62);
4. The Trainee or Intern named in this T/IPP will not displace full-or part-time, seasonal or permanent American workers, or serve to fill a labor need;
5. I will conduct the required periodic evaluations of the Trainee or Intern named in this T/IPP;
6. I will notify the designated Sponsor contact at the earliest available opportunity regarding any concerns about, changes in, or deviations from this
T/IPP.
7. I will notify the Sponsor in the event of an emergency involving the Trainee or Intern named in this T/IPP, as well as any information that I receive
about the Trainee or Intern that might have an effect on that exchange visitor's health, safety, or welfare;
8. I will notify the Sponsor if I receive information regarding a serious problem or controversy involving the Trainee or Intern named in this T/IPP that
could be expected to bring the Department of State, the Exchange Visitor Program, or the Sponsor's exchange visitor program into notoriety or
disrepute;
9. I am participating in this Exchange Visitor Program in order to provide the Trainee or Intern named in this T/IPP with training or an internship as
delineated in this T/IPP;
10. I certify that this training or internship meets all the requirements of the Fair Labor Standards Act, as amended (29 U.S.C. 201 et seq.) I also
certify that training or internships in the field of agriculture meet all requirements of the Migrant and Seasonal Worker Protection Act, as amended
(29 U.S.C. 1801 et seq.).
11. I declare and affirm under penalty of perjury that the statements and information made herein are true and correct to the best of my knowledge,
information and belief. The law provides severe penalties for knowingly and willfully falsifying or concealing a material fact, or using any false
document in the submission of this form.
Signature of Supervisor
PURPOSE: The information solicited on this form will be used to provide clarity of training and intern programs offered by entities designated by the
U.S. Department of State to conduct exchange visitor programs; for general statistical use; and to administer the Trainee and Intern categories of the
Exchange Visitor Program.
ROUTINE USES: The information on this form may be shared with entities administering the program on behalf of the Department; federal, state,
local, or foreign government entities for law enforcement purposes; to members of Congress in response to a request on your behalf . More
information on the Routine Uses for the system can be found in the System of Records Notice State-08, Educational and Cultural Exchange Program
Records.
DISCLOSURE: Participation in this program is voluntary; however, failure to provide the information may delay or prevent participation in the
Exchange Visitor Program.
PAPER WORK REDUCTION ACT
Public reporting burden for this collection of information is estimated to average 2 hours per response, including time required for searching existing
data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection. You do
not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy of this
burden estimate and/or recommendations for reducing it, please send them to: ECA/EC, SA-4, U.S. Department of State, Washington, DC 20522.
DS-7002 Page 5 of 5
02-2018
Juliana
Email: juliana.baptista@fourseasons.com
Ryan Schmitt
Email: ryan.schmitt@fourseasons.com
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