Personal Information 1

• Surname: please write your surname as it is written in your passport. Please write it using English language letters if your name contains non-English letters.
• Given name: please write your given name as it is written in your passport. Please write it using English language letters if your name contains non-English letters.
• Full name in native alphabet: please write your full name as it is written in your local language
• Have you ever had other names?: unless you have legally changed names, please answer “No”
• Do you have a telecode that represents your name?: please choose “No”
• Sex: please write down whether you are male or female per your passport
• Marital status: please choose “Single”
• Date of birth: please write your date of birth
• City: please write the city you were born in per your passport
• State/Province: please write your state or province you were born in or choose “Does not apply”
• Country/Region: please choose the country you are born in per your passport

Personal Information 2

• Country/Region of Origin/Nationality: please choose your nationality per your passport
• Do you hold or have held a nationality other than the one you have indicated above?: unless you are or have been a national/citizen of another country, please answer “No”
• Are you a permanent resident of a country/region other than your country/region of origin (nationality)?: unless you are a legal resident of another country, please answer “No”
• National Identification Number: please choose “Does not apply”
• US Social Security Number: please choose “Does not apply”
• US Taxpayer ID Number: please choose “Does not apply”

Address and Phone Information

• Street Address (Line 1): the name of the street you live on at home
• Street Address (Line 2): fill out if necessary, otherwise leave blank
• City: the name of city you live in at home
• State/Province: enter your state/province or choose ”Does not apply”
• Postal Zone/Zip Code: please enter the zip code of your address at home
• Country/Region: please enter the country you live in at home
• Mailing Address: choose ”Yes” if your mailing address is the same as your home address. This is the address your passport with the visa will be sent to after your visa appointment
• Phone: please enter your phone number. This is the phone number the embassy will call in case they have questions
• Secondary Phone Number: please share another phone number if you wish or choose “Does not apply”
• Work Phone Number: please choose”Does not apply”
• Email Address: please enter your email address

Passport Information

• Passport/Travel Document Type: choose ”Regular”
• Passport/Travel Document Number: please write passport number as it is written in your passport
• Passport Book Number: please choose “Does not apply”
• Country/Authority that issued Passport/Travel Document: please choose the country that issued your passport per your passport
• Where was the passport/travel document issued?

1. City: please enter the city as it is written in the passport
2. State/Province: please enter the state/province or leave empty if it does not apply
3. Country/Region: please enter the country

• Issuance Date: please write the date the passport is issued per the date in the passport
• Expiration Date: please write the date the passport expires per the date in the passport
• Have you ever lost a passport or had one stolen?: if not, please answer no. If yes, please add additional information

Travel Information

• Purpose of Trip to to the U.S.: please choose “EXCHANGE VISITOR (J)”
• Specify: please choose “EXCHANGE VISITOR (J1)”
• Intended date of arrival: please choose the start date from point #3 on the DS-2019 form
• Intended length of stay: please choose ”11” and ”months”
• Address where you will stay in the U.S.

1. Please write the full address of your host family
2. OR, if you do not know your host family yet, please write the address from point #7 on the DS-2019 form

• Person/Entity Paying for Your Trip: please choose “Someone else”
• Please enter the following information about one of your parents:

1. Name
2. Telephone number
3. Relationship to you: please write “Parent”
4. Please write the full address

Travel Companions Information

• Persons traveling with you: please choose ”No”

Previous U.S. Travel Information

Please answer all questions honestly. If you select “Yes” to any of them, you will be asked to provide additional information.

• Have you ever been in the US?
• Have you ever been issued a U.S. visa?
• The visa waiver program, like ESTA for tourists, is NOT considered a visa
• Have you ever been refused a U.S. visa or been refused admission to the United States or withdrawn your application for admission at the port of entry?
• Have you ever been denied travel authorization by the Department of Homeland Security through the Electronic System for Travel Authorization (ESTA)?
• Has anyone ever filed an immigrant petition on your behalf with the United States Citizenship and Immigration Services?

U.S Point of Contact Information

• Contact Person

1. Please write the name from point #7 in the DS-2019 form
2. Please write ”EF Foundation” for Organization Name

• Relationship to you – please write ”OTHER”
• Address and Phone Number of Point of Contact – please fill out the address and contact information from point #7 in the DS-2019 form

Family Information: Relatives

• Father’s Full Name and Date of Birth

1. Surname: Please write your father’s last name
2. Given Name: Please write your father’s first name(s)
3. Date of Birth: Please write your father’s birthday
4. Is your father in the U.S.? Please answer ”Yes” or ”No”

• Mother’s Full Name and Date of Birth

1. Surname: Please write your mother’s last name
2. Given Name: Please write your mother’s first name(s)
3. Date of Birth: Please write your mother’s birthday
4. Is your mother in the U.S.? Please answer ”Yes” or ”No”

Family Information: Relatives

• Father’s Full Name and Date of Birth

1. Surname: Please write your father’s last name
2. Given Name: Please write your father’s first name(s)
3. Date of Birth: Please write your father’s birthday
4. Is your father in the U.S.? Please answer ”Yes” or ”No”

• Mother’s Full Name and Date of Birth

1. Surname: Please write your mother’s last name
2. Given Name: Please write your mother’s first name(s)
3. Date of Birth: Please write your mother’s birthday
4. Is your mother in the U.S.? Please answer ”Yes” or ”No”

• Do you have any immediate relatives, not including parents, in the United States? Please answer ”Yes” or ”No”
• Do you have any other relatives in the United States? Please answer ”Yes” or ”No”

U.S Point of Contact Information

• Contact Person

1. Please write the name from point #7 in the DS-2019 form
2. Please write ”EF Foundation” for Organization Name

• Relationship to you – please write ”OTHER”
• Address and Phone Number of Point of Contact – please fill out the address and contact information from point #7 in the DS-2019 form

Present Work/Education/Training Information

• Primary Occupation: please select “Student”
• Present employer or school name: please write the name, address amd contact details for your current school at home
• Monthly income: please choose “Does not apply”
• Briefly describe your duties: please write “I AM A FULL TIME STUDENT IN SCHOOL”

Previous Work/Education/Training Information

• Were you previously employed?: please choose “No” if you have not been employed.
• If “Yes” then please fill out the information about your former employer
• Only answer “Yes” if you have worked full-time within the last 5 years

Security and Background: Part 1,2,3,4 and 5

Please answer all questions honestly with “Yes” or “No”.

Additional Point of Contact Information

• Please write the contact information for two people you are not directly related to such as a neighbor or close friend.

SEVIS Information

• SEVIS ID: you find your SEVIS ID at point #1, to the right on the DS-2019 form. It starts with N00.
• Program Number: you find this number under point #2 on the DS-2019 form
• Do you intend to study in the U.S.?: please choose “Yes”
• Then fill out the information from point #1, ”primary site activity” on your DS-2019 form

Upload Photo

• Please upload a picture in JPEG format. The file must not be larger than 240 KB in size. You need to have the picture taken by a photographer in the size 51 mm x 51 mm. Please ask for a digital copy and a hard copy you can bring to the visa interview. You can also choose to continue without a photo and only bring a copy to the interview.

Personal, Address, Phone and Passport Information

• Please review all information and check to see if it is correct. After this step you will go through all steps again to double check.

Sign and Submit

• Please review all application steps again, fill out your passport number and write the code that appears to the right. This is your digital signature. Once done, please press ”Submit”

You are now done with your application and will be redirected to a confirmation page. It is VERY important that you print this confirmation page and the entire application. Please ensure the barcode is visible and clear in the top, right corner. You will bring this paperwork with you to the embassy.