DS-2019 Department Request for Exchange Visitor (EV)

DS-2019 Department Request for Exchange Visitor (EV)

College of Engineering 6-26-2023
*

Apply to an American consulate for a J-1 visa to ENTER the United StatesTRANSFER TO UK from another U.S. institutionApply for CHANGE OF STATUS TO J-1 within the United States
JV Account Number*
UK Department*
Surname (Family)*
Given (First)*
Middle
Please provide a start date at least 4 months into the future to allow plenty of time for processing.
Start Date*

MonthDayYear
Date
End Date*

MonthDayYear
Date
EV’s will not be allowed to enter the United States more than 30 days before or 30 days after the start date indicated on the DS-2019. If the EV’s arrival is going to be delayed beyond the program start date, please contact valerie.pitts@uky.edu to proceed with an amendment
US State Department Definitions

Research ScholarShort-Term ScholarSpecialistStudent Intern
UK Human Resources Definitions

Postdoctoral ScholarVisiting ScholarVisiting Student
Subject or Field of Engagement (such as biomedical sciences, engineering, etc.)*
**Find the correct code here (EX: 01.0001). Please note that the subject or field of engagement may not be changed for the duration of the EV's DS-2019.
Enter Detailed Explanation of Research & Duties This Exchange Visitor Will Be Doing*
Source of Funding*
Per Month (USD)*
Per Year (USD)*
Funding must be secured for the initial period requested. Minimum funding required:
- J-1 Scholar: $ 22,000
- J-1 Scholar and Spouse: $ 28,800
- Each child, an additional: $ 4,700
UK funding?*

YesNo
UK funding. Specify grant account number(s)*
Non-UK funding. Provide an official letter from the funding source specifying the duration of stay and amount of funding in U.S. currency.*

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Professor who will be working with the candidate*

First NameLast Name
Professor Phone Number*
Professor Email*
example@example.com
Working address (at UK) of candidate:
Street Address*
(Example: 512 Administration Drive)
Lab/ Room #*
(Example: FPAT)
Zip*
City*
State*
The Photocopy of the offer letter from the Business Office*

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Is the participant a physician?*

YesNo
If the participant is a physician, an additional letter from the Dean of the Medical School or designee is required. This letter should indicate that the research program either does not involve patient contact/care or it involves only incidental patient contact.*

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By approving this form, I request a DS-2019 “Certificate of Eligibility” for this candidate. I understand that I am responsible for the processing fees charged by the International Student and Scholar Services (ISSS).

The fee will be charged to me by a journal voucher prepared by ISSS.
Should be Empty: