Authorization Code
*
Start Form
J1 Visa
Name
*
First Name
Last Name
Name of Camp
*
Please Select
American Summers
Akeela
Akeela Wisconsin
Cobbossee
Danbee
Kippewa
Lake of the Woods
Mah-Kee-Nac
Odyssey Teen Camp
Ramaquois
Shibley
Walt Whitman
Watitoh
Wicosuta
Winadu
Winaukee
Zeal
Position at Camp
*
Type of Visa
*
Camp Counselor
Summer Work Travel
Camp Contract
*
Upload a File
Please attach a copy of your SIGNED camp contract.
Cancel
of
Contract Start Date
*
-
Month
-
Day
Year
Date Picker Icon
Contract End Date
*
-
Month
-
Day
Year
Date Picker Icon
Occupation
*
Please Select
University Undergraduate Student
University Graduate Student
Civil Service Employee in Regional/State Government
Civil Service Employee in Central Government
Civil Service Employee in City/Town Government
University Teach Staff
University Administrative Staff
University, Other
Secondary School Principal
Secondary School Teacher or Staff
Secondary, Other
Elementary School Teacher, Principal, or Staff
Elementary, Other
Special School Institute or Vocational Teacher or Staff
Private Sector
Private Business Group
Manager Employed by Private Business Group
Employee of Private Business
Private Business, Other
Self Employed Prof. Group
Independent or Nonprofit Hospital or Other Org. Group
The Arts
Composer or Musician
Athlete
Coach
Sports, Other
Labor
Electronic Media Group
Is this your first J-1 Visa?
*
Yes
No
If no, how many J-1 Visas have you had?
Please indicate the year, the visa category, and the sponsoring organization. For example, 2 - Camp Counselor - CCUSA
Applicant Information
It is important that you enter this information as it appears on your passport.
Name
*
First Name
Middle Name
Last Name
Birth Date
*
-
Month
-
Day
Year
Date Picker Icon
Gender
*
Male
Female
City of Birth
*
Please enter the unabbreviated City in which you were born.
Country of Birth
*
Please enter the unabbreviated Country in which you were born.
Citizenship
*
Please enter the unabbreviated Country in which you maintain Citizenship.
Country of Legal Residence
*
Please enter the unabbreviated country in which you are a legal permanent residence.
Passport Number
*
Please supply us with your full passport number.
Issuing Country
*
Please enter the name of country which issues your passport.
Copy of Passport
*
Please attach a copy of the BIOGRAPHICAL page of your passport for verification.
University Information
Name of School
Field of Study
Year in School
Please Select
1
2
3
4
5
Graduation Date
-
Month
-
Day
Year
Date Picker Icon
Will you be a full-time student next year?
Yes
No
Proof of Student Status
If you are applying for a Summer Work Travel Visa, you must be a full-time student. Please attach written proof of your student status. College ID card is not acceptable.
Contact Information
Present Address - This is the address you want your paperwork sent to. Must be able to receive FedEx.
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Permanent Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Phone Number
*
-
Country Code
-
Area Code
Phone Number
E-mail
*
Emergency Contact Information
Emergency Contact Name
*
First Name
Last Name
Relationship
*
Emergency Contact Phone Number
*
-
Country Code
-
Area Code
Phone Number
Emergency Contact E-mail
*
Applicant Agreement
I have read and agree to the Terms and Conditions (http://www.greatcampjobs.com/j1visa_terms.htm) outlined by CampGroup, LLC. As part of the agreement, I will be enrolled in the medical insurance program. I know of no reason why I would be refused a visa from the U.S. Embassy or the U.S. Department of State. I attest that all information provided on this application is true and I understand that providing false or misleading information will result in the cancellation of my program.
Do you agree with the above statement?
*
Yes
No
Complete Form
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