J-1 Social Security Sign-up Day

J-1 Social Security Sign-up Day

Friday, July 14th at the Ephraim Village Hall
We are excited to help you get your Exchange Visitors signed up for their Social Security Card by appointment and without having to drive to Green Bay.
- All Sign-ups are By Appointment Only.
- A Host Employer may schedule 1 to 10+ students at a time, when possible.
- The Waiting Period for office visits IS WAIVED for our Sign-up Days.
- By requesting an appointment, you agree to help each student complete the steps of the Sign-up Days Checklist prior to their appointment. (See link on confirmation page.)
H2B, Name Changes, and Replacement Card Requests are also welcome to request an appointment.
Your Name*

First NameLast Name
Business*
US Postal Service Mailing Address for Your Business*

PO Box or USPS Delivery Address

Address 2

CityState / Province

Postal / Zip Code
Your Email*
example@example.com - for confirmation & updates.
Direct Phone Number
Ideally a cell phone to reach you in the event something was left behind or SSA has a question. Format: (000) 000-0000.
Number of Students*
We can accommodate 1-10 students at one appointment time.
Friday, July 14th
10:00am - 10:40am11am - 11:30am2pm - 2:40pm
I agree to help my student(s) complete the steps in the Appointment Checklist.I would rather walk to Green Bay than complete your stinkin' checklist.
Sponsor(s)
Which Sponsors are you working with this year? This is optional, but it is our only source for this information.
Country(s) of Origin
Knowing where our exchange visitors come from helps the DC BRIDGES program identify needs and opportunities, and helps us celebrate the breathe of cultural diversity they bring to our community!
Notes, Comments, Questions
If you need multiple appointments, please let us know what you need and when. Also, feedback is welcomed!
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