J1 Teach USA Application Form
Instructions: Before you start this application, ensure to the have the required documents. The list of documents needed have been shared by email. If you have any questions, please email TEACHUSA@thepassportja.com
Personal Details
Name
*
First Name
Last Name
Gender
*
Female
Male
Date of Birth
*
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Eligibility Requirement
Do you have Bachelors Degree in Education? (Only Bachelors Degree are accepted)
*
Yes
Select your Teaching Category
*
Early Childhood Education
Primary Education
Secondary Education
Other
If you select other, please explain:
*
How many years of experience do you have in field? (You must have minimum 2 years)
*
Do you have any Special Needs Training
*
Yes
No
Country Residence
Birth City:
*
Birth Country:
*
Resident of:
*
Citizen of:
*
Health History
Do you have an illness that may impair your ability to work?
*
Are you taking any medications?
*
Yes
No
If yes, state:
Are you Covid-19 vaccinated?
*
Yes
No
If yes, state the manufacturer:
Travel History
Do you have travel History within the past 5 years?
*
Yes
No
Do you have a US Visitor Visa?
*
Yes
No
Visa Control Number
Visa issue date:
-
Month
-
Day
Year
Date
Visa expiry date:
-
Month
-
Day
Year
Date
Have you ever been denied a visa?
*
Yes
No
If yes, please state why?
Have you ever been denied entry, or your visa revoked?
*
Yes
No
Have you ever been arrested or have any cases before the court?
*
Yes
No
J-1 Program History
Have you participated in any Bridge USA Program?
*
Yes
No
Which program?
For example: Summer Work and Travel
Document Upload
Digital Passport Photo
*
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of
Passport Bio Page
*
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of
University Degree
*
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of
Professional Resume
*
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of
Signed J-1 Teach USA Program Terms and Conditions - GEC
*
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of
Payment
Select your Country Location
*
Jamaica
Other Caribbean Country
Upload Payment Receipt
*
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Cancel
of
*
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( X )
Program Fee Deposit
$
300.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Signature
*
Submit
Should be Empty: