CAREER TRAINING USA

Intern/Trainee Application for J-1 Visa Sponsorship

PROGRAM DESCRIPTION
InterExchange Career Training USA is designated to sponsor two J-1 Visa categories: Intern and Trainee. You must determine which program is
appropriate before you complete the application. Please also visit www.InterExchange.org/ct-participant-requirements to view any updates to these
requirements.

Intern Trainee

Eligibility Currently enrolled in a degree- or professional A degree or professional certificate from a foreign post-
certificate-granting post-secondary (above high secondary academic institution and at least one year* of
school) academic institution outside the USA related professional experience acquired outside the USA
OR OR
Have graduated from such an institution no more than Five years* of related professional experience acquired
12 months before program start date outside the USA

Duration Up to 12 months Up to 18 months**

Program Focus Internship must be related to academic field of study Training program must be related to occupational field

Repeat Participation Yes, if still a student or recent graduate (current Yes, but must wait at least 2 years after the end of a
students must return to school for at least one term previous J-1 Intern or Trainee program. (This applies to all
before reapplying for the Intern visa) participants and is not related to Rule 212(e).)

* If your program eligibility is based on years of experience, your letters of reference must be from former employers who can fully document your length of employment. More
than 2 letters of reference or additional verification of employment may be required to determine your eligibility. Please also note that U.S. work experience cannot be considered
for program eligibility, per federal regulations.
** H
 ospitality & Tourism training programs cannot exceed 12 months.

ADDITIONAL PROGRAM REQUIREMENTS

 Your host employer must be eligible to host interns/trainees. See www.InterExchange.org/ct-employer-requirements for more details.
 You must be between the ages of 18 and 38.
 Your internship or training program must be related to your studies (Interns) and/or professional experience (Trainees).
 You must be interviewed in-person, over the phone or via web camera by InterExchange or an approved InterExchange partner.
 You must have verifiable English language skills and possess comprehension of English terminology of your field.
  ou must be covered by sufficient Accident & Sickness insurance for the length of your stay in the United States prior to your arrival in the USA, in
Y
accordance with US State Department regulations. Insurance is included in your program fee, and you may not decline this coverage.
 You must have sufficient funds to support yourself during your entire stay in the USA (including housing and living costs).
  our internship must be in a field that InterExchange is designated to sponsor, including the following: Architecture, Business, Commerce &
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Finance, Engineering, Hospitality & Tourism, Information Media & Communications, Management, Marketing & Sales, Public Administration & Law,
the Sciences, and Industrial Occupations. InterExchange cannot sponsor training programs in the arts (Arts Administration is allowed), medicine,
teaching, social work, or manual labor.
  ou must be applying for the J-1 visa from outside the USA. If you require a change of status to obtain the J-1 visa, you will not be eligible to
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apply through InterExchange. If you recently completed a degree and/or OPT within the USA, you may not apply for J-1 visa sponsorship through
InterExchange. Similarly, if you recently spent significant time in the U.S., you may not be eligible to apply at this time. Contact InterExchange to
discuss your specific circumstances before applying.

If you are already in the USA on an InterExchange Career Training USA program, you may be eligible to extend your program. Please contact us for
the appropriate application.

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 CAREER TRAINING USA Intern/Trainee Application

Application Checklist
Applicant Name:

International cooperator/university/law firm

assisting with application (if applicable):

Complete and attach this form to your completed application. Please do not submit your application until you have gathered all the required
materials—we cannot review applications that are incomplete.

 APPLICATION FORM  REQUIRED SUPPLEMENTAL DOCUMENTS

2 passport-sized, color photos All documents must be in English or translated into English
by an OFFICIAL English translator. All translations must be
Full program fees accompanied by the original documents.
Payment Method: (check the appropriate option) Copy of official transcript, degree/certificate, or signed statement
Completed Fee Payment Form enclosed from a post-secondary academic institution outside the USA
indicating that you are either currently enrolled or have graduated
Online Payment
Confirmation #: 2 letters of reference (Trainees’ letters must also confirm length of
employment.) Ensure that your letters:
Check/Money Order (attached)
Have been written and dated in the last 12 months by a
Application form (must be typed)
previous or current non-U.S. employer or professor
Applicant Information
Are signed by the reference
Internship/Training Objectives
Are completed on letterhead or have reference’s business
Résumé (Please attach a separate document with any details card attached
that do not fit on this form)
Indicate reference’s relationship to you
Cost of Living Worksheet (Research your host city and provide
Include exact dates of employment (for Trainees)
an estimate)
Additional letters for verifying previous employment, if applicable
Participant Agreement Form (must indicate email address and
(see Program Description on Page 1 for more details)
be hand signed and dated)
Interview Form completed by international cooperator
(independent applicants will be interviewed via phone by
InterExchange after your application is reviewed)
 EMPLOYER DOCUMENTS
Copy of passport photo page (passport must be valid at least
You must collect and submit all required employer documents 6 months past program end date)
with your application—see the employer application for full details
Copy of all previous U.S. visas
and checklist
Copy of your bank statement or a signed statement from a parent/
guardian to prove that you will have sufficient funds for the entire
length of your program.
Copy of DS-7002 Form for any previous J-1 Intern/Trainee Visas

 FOR DEPENDENTS  PROCESSING TIME

Copy of passport photo page for each dependent (passport must Our review time is approximately two weeks once we receive a
be valid at least 6 months past program end date) complete application and full payment. We will not review your
application until all documents and payment have been submitted. If
Copy of all previous U.S. visas for each dependent your employer requires a site visit the review process may take longer.
Signed dependent agreement for each dependent over age 18-- See the Employer Application for more information about site visits.
applicant must sign a dependent agreement for any dependents We do not expedite the review under any circumstances--please
under 18 apply at least 2 months before your start date to allow sufficient time
Full program and insurance fees for each dependent for the InterExchange application review and Embassy/Consulate
appointment, as well as to finalize your travel arrangements.

 SUBMISSION INSTRUCTIONS  NOTES

Option 1: Email to [email protected] Please make copies of all documents before submitting to
InterExchange. Original documents will not be returned once
Option 2: Mail to: submitted for review.
InterExchange, Inc
Career Training USA We do not make any promise or guarantee that visa sponsorship
161 Sixth Avenue, 10th Floor will be granted or that you will receive a visa from the Embassy/
New York, NY 10013 Consulate. It is highly recommended that you do not purchase non-
United States refundable airfare prior to visa issuance.

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 CAREER TRAINING USA Intern/Trainee Application

Print name exactly as it appears on your passport. Application must be typed.

(See cover page for program details)

Program you are applying for:

Intern Attach photo here.
Trainee smile

 APPLICANT INFORMATION Photos should be

no larger than the space
provided here.

FAMILY NAME FIRST NAME MIDDLE NAME

Male Female
DATE OF BIRTH (MM/DD/YYYY) SEX CITY OF BIRTH

COUNTRY OF BIRTH COUNTRY OF LEGAL PERMANENT RESIDENCY COUNTRY OF CITIZENSHIP (COUNTRY ISSUING PASSPORT)

EMAIL ADDRESS (REQUIRED—THIS IS HOW WE COMMUNICATE WITH APPLICANTS) SKYPE ID (IF APPLICABLE)

— —
COUNTRY CODE – CITY CODE – PHONE NUMBER

YOUR PRESENT SHIPPING ADDRESS (WHERE UPS CAN DELIVER)

CITY COUNTRY POSTAL CODE

 EMPLOYER INFORMATION

HOST EMPLOYER/COMPANY NAME SUPERVISOR NAME (LAST, FIRST)

EMPLOYER ADDRESS (ACTUAL LOCATION OF INTERNSHIP/TRAINING PROGRAM CITY STATE ZIP CODE

SUPERVISOR PHONE SUPERVISOR EMAIL ADDRESS

 PROGRAM LENGTH
 xpected Start Date: (The date you will
E  rogram Duration in Months:
P
start working at your host company) 1-12 Months (Interns & Hospitality Trainees);
MM/DD/YYYY 1-18 Months (Trainees - non-Hospitality) FULL MONTHS ONLY

 DEPENDENT INFORMATION
If you are married and/or you have children and plan to bring them with you to the USA, complete the information below. If you have more than 1
dependent, provide the information on separate paper and attach a copy of each dependent’s passport. All dependents must also be covered by
Accident and Sickness Insurance for the entire duration of the program. Please provide full program and insurance fees for all dependents.

Are you bringing dependent(s) with you to the USA? Yes No How many?

FAMILY NAME FIRST NAME MIDDLE NAME

Spouse Child Male Female

RELATIONSHIP OF DEPENDENT TO TRAINEE SEX DATE OF BIRTH: (MM/DD/YYYY) CITY OF BIRTH

COUNTRY OF BIRTH COUNTRY OF LEGAL PERMANENT RESIDENCY COUNTRY OF CITIZENSHIP (COUNTRY ISSUING PASSPORT)

Dependents must also sign the agreement form on page 17.

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 CAREER TRAINING USA Intern/Trainee Application

 EDUCATIONAL AND PROFESSIONAL INFORMATION

Please provide details regarding your educational and professional background in the Résumé section on Page 5.
Are you currently enrolled in school? Yes No If not a student, what is your current profession?

Proposed field of internship/training program:

Years of work experience related to the field of internship/training program:

 APPLICANT US TRAVEL HISTORY

Are you currently in the USA on a visa or tourist waiver? Yes No

If yes, what is your intended date of departure from the USA? _____________ (MM/DD/YYYY) Attach copy of return ticket indicating departure date.
Have you ever visited, worked, lived or studied in the USA? Yes No
If Yes, please list dates, visa type, and name of program/sponsor for each trip. Attach copy of all visa(s) and tourist waivers from the past ten years.
Use additional sheets to list more visas and travel dates.

DATES - MM/DD/YYYY VISA TYPE REASON FOR TRAVEL

EXACT ARRIVAL EXACT DEPARTURE

Have you ever been denied a visa or denied entry to the USA? Yes No
If yes, please explain:

Have you ever been convicted of a crime in the USA or in your home country? Yes No
If yes, please explain:

 APPLICANT MEDICAL HISTORY

Please state all previous or current medical conditions, hospitalizations, and surgeries:

Are you presently on any medication or seeking medical treatment? If yes, explain:

If you were previously on medication or sought medical treatment, was the medication and treatment discontinued with your doctor’s consent?
 Yes or  No. If no, please explain:

 APPLICANT’S EMERGENCY CONTACT INFORMATION

Your emergency contact must speak English. Please provide the name of a relative, spouse, or someone who knows you well.

ENGLISH SPEAKING EMERGENCY CONTACT NAME RELATIONSHIP TO APPLICANT

— —
COUNTRY CODE – CITY CODE – PHONE NUMBER EMERGENCY CONTACT EMAIL ADDRESS

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 CAREER TRAINING USA Intern/Trainee Application

Résumé
You must complete this form - please attach a separate sheet with any information that does not fit on this form.

 PERSONAL INFORMATION

LAST NAME FIRST NAME

 EDUCATIONAL BACKGROUND Please list most recent education first, excluding high school.

NAME OF ACADEMIC INSTITUTION CITY COUNTRY

- DEGREE AWARDED? Yes No

DATES ATTENDED (MM/DD/YYYY - MM/DD/YYYY) FIELD OF STUDY TYPE OF DEGREE PROGRAM
Bachelor's

Master's

Certificate
WEBSITE
Other

NAME OF ACADEMIC INSTITUTION CITY COUNTRY

- DEGREE AWARDED? Yes No

DATES ATTENDED (MM/DD/YYYY - MM/DD/YYYY) FIELD OF STUDY TYPE OF DEGREE PROGRAM
Bachelor's

Master's

Certificate
WEBSITE
Other

NAME OF ACADEMIC INSTITUTION CITY COUNTRY

- DEGREE AWARDED? Yes No

DATES ATTENDED (MM/DD/YYYY - MM/DD/YYYY) FIELD OF STUDY TYPE OF DEGREE PROGRAM
Bachelor's

Master's

Certificate
WEBSITE
Other

 WORK EXPERIENCE Please list most recent experience first.

COMPANY NAME JOB TITLE

-
CITY COUNTRY DATES OF EMPLOYMENT (MM/DD/YYYY - MM/DD/YYYY)

Descriptions of Roles and Responsibilities (list as bullet points):

COMPANY NAME JOB TITLE

-
CITY COUNTRY DATES OF EMPLOYMENT (MM/DD/YYYY - MM/DD/YYYY)

Descriptions of Roles and Responsibilities (list as bullet points):

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 CAREER TRAINING USA Intern/Trainee Application

 WORK EXPERIENCE Please list most recent experience first.

COMPANY NAME JOB TITLE

-
CITY COUNTRY DATES OF EMPLOYMENT (MM/DD/YYYY - MM/DD/YYYY)

Descriptions of Roles and Responsibilities (list as bullet points):

COMPANY NAME JOB TITLE

-
CITY COUNTRY DATES OF EMPLOYMENT (MM/DD/YYYY - MM/DD/YYYY)

Descriptions of Roles and Responsibilities (list as bullet points):

 SKILLS

Beginner Intermediate Advanced Fluent Native

LANGUAGE LEVEL OF PROFICIENCY

Beginner Intermediate Advanced Fluent Native

LANGUAGE LEVEL OF PROFICIENCY

Beginner Intermediate Advanced Fluent Native

LANGUAGE LEVEL OF PROFICIENCY

Computer/Technical Skills (Please include knowledge of software programs - e.g., Adobe Photoshop):

Certifications/Relevant Coursework:

Other skills related to industry in which you are seeking an Intership (Please include emberships to any professional organizations):

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 CAREER TRAINING USA Intern/Trainee Application

 INTERNSHIP/TRAINING OBJECTIVES

1. W
 hy are you qualified to participate in an internship/training program in the U.S.?
Discuss education, work experience, and preparations you have undertaken.

2. What skills and knowledge do you expect to gain during each of the phases of your internship/training in the U.S.?

3. How would successful completion of an internship/training program in the U.S. assist you in your future?

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 CAREER TRAINING USA Intern/Trainee Application

Cost of Living Worksheet

Interns and Trainees must have sufficient funds to support themselves for their entire stay in the USA. Please estimate the amount of money you will
need upon arrival, as well as your expected monthly expenses. You may consult your host employer for information about the cost of living in their
area.

STIPEND/SALARY $_ _ _ _ _ _ _ _ _ _ _ _ _ _per_ _ _ _ _ _ _ _
(HOUR, DAY, MONTH, ETC.)

ONE-TIME EXPENSES MONTHLY EXPENSES

(These are costs you may incur upon arrival in the United States)

Hotel upon arrival Monthly rent

Furniture/Housewares Food & other groceries

Security deposit for an apartment Commuting costs

(usually equivalent to one month rent. (e.g., gas, parking, tolls, bus, subway)
May require last month rent as well.)
Laundry/Dry cleaning

Internet

Phone

Utilities (e.g., water, heat, electricity)

Other (cable, medicine)

Total one-time expenses 0 Total monthly expenses 0

Have you already secured housing? Yes No

Will you be paying for housing in the USA? Yes No

If no:
Paid for by employer
Living with friend/family member
Other Please explain:

Will you be paying for transportation costs in the USA? Yes No

If no:
Paid for by employer
No transportation costs necessary to commute from housing to employer
Other Please explain:

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 CAREER TRAINING USA Intern/Trainee Application

Proof of Sufficient Funds

Please select the appropriate option below. If applicants are supporting themselves, they should include their stipend/salary provided by their
employer (if applicable), as well as their own available personal funds in the monthly amount stated below.

OPTION 1:

Applicant Supporting Self

I certify that I have the amount of $ (USD) per month available to support myself during my internship/training program in the U.S. I
have attached proof of my available funds.

Applicant's Handwritten Signature Date

OPTION 2:

Applicant Supported by Parent/Guardian/Spouse/Current Employer in Home Country

Name:

Relationship to Applicant:

I certify that I have the amount of $ (USD) per month available to support

while he/she is completing an internship/training program in the U.S.

(applicant’s full name)

I have attached proof of my available funds.

Handwritten Signature Date

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 CAREER TRAINING USA Intern/Trainee Application

CAREER TRAINING USA

Fee Payment Information
Payment is accepted by:

1 Check or Money Order drawn on a U.S. bank account in U.S. dollars, payable to InterExchange, Inc.


2 Credit Card (Visa, MasterCard, American Express or Discover)

• Online (preferred method) at http://www3.interexchange.org/payonline/
• By email, fax or mail: Fill in the form below for credit card authorization. Please return this form to InterExchange via email,
fax or mail.
Email: [email protected]
Fax: (212) 924-0575, ATTN: Finance Department
Mail: InterExchange, Inc.
Career Training USA Program
161 Sixth Avenue, 10th Floor
New York, NY 10013

Participant Name: Program Length: months

LAST NAME FIRST NAME

Program Dependent Fee Due Host Employer Site Visit Fee Total
Fee Due: $ (if applicable): $ (if not being paid by employer): $ Fees Due: $

I/we specifically authorize InterExchange to charge US$ for the Career Training USA Program to my/our (check one):

Card Type: Visa MasterCard American Express Discover

Security Exp.
Card Number: — — — Code: Date:
MM/YYYY

Name as it appears on the card:

Billing Address:
STREET ADDRESS

CITY STATE/PROVINCE ZIP/POSTAL CODE COUNTRY

 I authorize InterExchange, Inc. to charge my credit card according to the details above.
 I certify that I have reviewed and agree to the InterExchange Career Training USA Fee & Refund Schedule.

 Please sign below.

Credit/Debit Card Holder’s Signature: Date:

MM/DD/YYYY

Thank you!

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 CAREER TRAINING USA Intern/Trainee Application

INTEREXCHANGE, INC.
Career Training USA Participant Agreement
This Agreement by and between InterExchange, Inc., a 501(c) (3) organization located at 161 Sixth Avenue, New York, NY 10013, and me as a
Participant (herein “Participant”) defines the terms and conditions between InterExchange and myself regarding InterExchange’s Sponsorship of
my J-1 Visa for the Exchange Visitor Program, which involves a Host Employer providing professional training to me. I understand that my training
will be in compliance with the terms and conditions set forth in an approved Training/Internship Placement Plan.

BACKGROUND d. U.S. Embassy or Consulate. I understand that InterExchange has no control over
the actions or decisions of the U.S. embassy or consulate in my country of residence
InterExchange is a designated Sponsor of the J-1 Intern and Trainee Visa Programs administered regarding issuing the J-1 Visa. The decision is at the sole discretion of the embassy/
by the U.S. Department of State’s Bureau of Educational and Cultural Affairs. The Cultural consulate. In compliance with the terms of this Agreement, I understand that I must
Exchange Program allows InterExchange Intern or Trainee Participants to gain practical training provide truthful responses during my interview and in all dealings with the U.S.
experience in their academic or occupational field with an appropriate American Host Employer government.
for up to twelve (12) to eighteen (18) months as determined by U.S. Department of State 4. Program
Program Regulations. a. Position
I agree to the following terms and conditions of the Program: (i) Training/Internship Placement Plan. I understand all Host Employers must
1. Definitions. The definitions for this Agreement are set forth in the document labeled “Career complete a Training/Internship Plan that is unique to my training goals and
Training USA Definitions”, which can be found in the Career Training Resource Center at the qualifications. I further understand the Host Employer, Intern/Trainee, and
following URL: InterExchange must sign the Training/Internship Plan DS-7002 Form to formally
http://www.interexchange.org/career-training-usa/internship-co-op-trainee-job/resources execute the document, which will be presented to the embassy/consulate during
By signing this Agreement, I certify that I read, understood and agree to the terms in Career the visa interview. Subject to the terms and conditions of this Agreement, I must
Training USA Definitions. notify InterExchange immediately if the Training/Internship Plan changes or is
not followed according to its terms.
2. Objective. I agree that InterExchange’s Career Training USA Program exists to enhance my
skills and expertise in my academic or occupational field through participation in a structured (ii) Limitations on Training/Internship Program. I agree to the following terms and
and guided work-based Training or Internship Program and to improve my knowledge of conditions:
American techniques and methodologies. Such Training and Internship Programs are also a. The Intern/Trainee J-1 Visa Program is not intended to be a substitute for
intended to increase my understanding of American culture and society and to enhance ordinary work purposes, and it is not intended under any circumstance to
American knowledge of foreign cultures and skills through an open interchange of ideas displace American workers, or be a conduit to permanent work and residency
between myself and my American associates. I agree to comply with the goals, objectives, in the USA.
Regulations, and policies of the J-1 Intern/Trainee Exchange Visitor Program (22 CFR Part b. I must not perform a Training/Internship Program that includes more
62.22) throughout the duration of the Program. I further understand that any conflict than twenty percent (20%) of basic and/or Clerical tasks. The purpose of
between the cultural exchange purposes of the Career Training USA Program and my duties this Program is to perform professional tasks and responsibilities and not
as an Intern or Trainee shall be decided in favor of the cultural exchange purposes of the Unskilled, Manual, or Casual Labor.
Program. c. I must not intern or train in child care or elder care, or in clinical or any other
3. Application, Interview, Selection & Decision Process kind of work that involves patient care or patient contact, including any work
a. Application. I agree to the following terms and conditions: that would require Trainees or Interns to provide therapy, medication, or
(i) Application. I agree to complete the Application as required by InterExchange other clinical or medical care (e.g., sports or physical therapy, psychological
and Program Regulations. I understand that the Application is incorporated into counseling, nursing, dentistry, veterinary medicine, social work, speech
this Agreement. Upon submission, I agree that my Application is the property of therapy, early childhood education).
InterExchange. I agree that original documents shall not be returned. I understand d. For Hospitality placements lasting six months or longer, I agree that the
that I may request copies of materials submitted with my original Application Training/Internship Plan must provide a minimum of three departmental or
provided, however, that I submit a notarized request specifying the documents functional rotations.
requested. I understand that such requests may only be fulfilled within one year of b. Cultural Exchange Events. I agree to attend Cultural Exchange Events that will provide
my Application submission date. me with exposure to the societal, cultural and historical elements as well as values of
(ii) Background Information. In compliance with the Background Information section the U.S. I agree to provide evidence that I attended Cultural Exchange Events in the U.S.
of the Agreement, I understand that background information in the Application and will describe my Cultural Exchange Events as a part of the Evaluation Forms (see
about myself is obtained for the sole purpose of determining my suitability for the below) that I am required to complete for the Program.
Program. c. Work Hours. I must pursue a full-time position (thirty-two (32) hours/week minimum)
(iii) Additional Application Documentation. I agree that InterExchange, at its sole as an Intern/Trainee. I understand that there is not an upper limit on the number of
discretion, may request additional documentation in order to make a final decision hours that a Host Employer may assign me and that details regarding compensation
about my Application. for work hours must be discussed and agreed to by my Host Employer and myself
(iv) Complete Application & Review Time. I understand that I must provide a prior to submitting the Program Application. I understand that all terms and conditions
complete Application and make full payment before InterExchange is required must be compliant with the requirements of U.S. labor and employment laws. I further
to render a decision to grant or deny Sponsorship. I understand that Application understand a failure to perform the terms of this clause shall be grounds for ending the
review timelines are estimates only, and I understand that the review is subject to Program and revoking my Sponsorship by InterExchange.
receipt of appropriate documentation as determined by InterExchange. d. Length of Program & Visa. I understand and agree that my Program participation
(v) Circumstances that may negate Application. I agree not to apply for begins on the day of my arrival into the U.S. and ends on the day of my departure from
InterExchange’s J-1 Visa Sponsorship if any of the following is true: the U.S. so long as this occurs within the legal Program dates as defined by my DS-
2019 Form and that I am in compliance with the rules and Regulations of the Program.
a. I reside in the U. S. I agree to apply for the J-1 Visa from outside the United I may arrive up to a maximum of 30 days prior to the program begin date on my DS-
States. 2019 Form, but I may not begin my training until the begin date on my DS-2019 Form.
b. I require a change of status from another U.S. government issued visa to the The thirty (30) days after the Program end date is my 30-Day Travel/Grace Period as
J-1 Visa. defined in this Agreement. I shall not leave and re-enter the U.S. during the 30-Travel/
c. I intend to train as an au pair, childcare giver, teacher, teaching assistant, camp Grace Period without first obtaining proper immigration documentation. I agree to the
counselor, ship or aircraft crew member, or a medical staff having patient specific terms of the length of my Program as follows:
contact. (i) If I am a Trainee, my training must not exceed eighteen (18) months, or, in the case
d. I do not intend to leave the U.S. upon successful completion of my J-1 Intern/ of Hospitality and Tourism, it must not exceed twelve (12) months, but, in either
Trainee Program. case, may be as short as one (1) month. I agree to only legally train with my Host
Employer within the Program begin and end dates listed on my DS-2019 Form.
e. I started my own company within the U.S., and I will use the J-1 Visa to work for
the company. (ii) If I am an Intern, my Internship must not exceed a maximum of twelve (12) months
but may be as short as one (1) month. I agree to only legally intern with my Host
f. I intend to violate the Regulations of the Program or laws of the U. S.
Employer within the Program begin and end dates listed on my DS-2019 Form.
g. I have a serious illness or condition (e.g., an illness that requires surgery or
(iii) If I am either a Trainee or an Intern, I must not leave the United States for more
ongoing therapeutic care) that will inhibit my ability to successfully fulfill the
than thirty (30) consecutive days once the Program begins.
terms of this Exchange Visitor Program and/or jeopardize my wellbeing.
(iv) If I am either a Trainee or an Intern, I must leave the United States within thirty
(vi) Visa Status and Application. I understand that a failure to accurately report
(30) days of quitting or being fired if I do not locate a new Host Employer under
my visa status to InterExchange shall result in the rejection of my Application. If
the terms and conditions set forth in this Agreement, including, without limitation,
Sponsorship was granted prior to the discovery of violation(s) of InterExchange
the submission and approval of a new Training/Internship Placement Plan prior
policy, InterExchange shall withdraw Sponsorship at the time of discovery and no
to starting a new Intern/Trainee position. I understand that I must leave the U.S.
refund shall be granted.
immediately if InterExchange ends my Sponsorship.
b. Third Parties (e.g., attorneys). I may apply to the Career Training USA Program without
(v) I must verify that all the details on my DS-2019 Form are accurate prior to attending
an attorney or assistance from a Third Party. Any fees or costs associated with the
my visa interview at the Embassy or Consulate. If I discover that any of the
use of a Third Party are my responsibility. InterExchange is not responsible for the
information is incorrect, I must return the incorrect DS-2019 Form to Career
conduct of the Third Party. I must inform InterExchange of any relationship with Third
Training USA, who will issue an updated DS-2019 Form. I understand that the time
Parties. In order for a Third Party to inquire about my Application or Program status, I
it may take to print and ship the DS-2019 Form may vary and visa appointments
must grant power of attorney to the Third Party, and I must provide written notice to
may need to be rescheduled at my own cost.
InterExchange before InterExchange will speak about either my Application or status.
e. Visa. I must complete all visa requirements in accordance with the instructions
c. Final Decision. I understand that InterExchange reserves the right to reject me as an
provided by the Embassy or Consulate at which I am applying and InterExchange (if
Applicant, my potential Host Employer, or my proposed Training/Internship Plan as
any).
described under my DS-7002 Form if InterExchange determines, at its sole discretion,
that either a party or the Training/Internship Placement Plan does not meet the f. Passport. I must hold a passport that is valid for six (6) months beyond the Program
requirements and objectives of the Regulations or InterExchange Program guidelines. end date.

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 CAREER TRAINING USA Intern/Trainee Application

g. Vaccination & Immunization. I must comply with all vaccination and immunization d. InterExchange Is Not My Host Employer. With the exception of Trainees or Interns hired
requirements. by InterExchange as temporary employees (see below), I agree that InterExchange is
h. Student and Exchange Visitor Information System (SEVIS). I must register with SEVIS neither my Host Employer nor an Employment Agency. Trainees or Interns working
in the manner described under the notice terms and conditions of this Agreement. I for InterExchange shall be so indicated by an Intern-Trainee letter of temporary
must read the terms and conditions carefully to understand the ramifications of failing employment that InterExchange’s Human Resources Department sends to Trainees/
to properly register with SEVIS. Interns hired by InterExchange.
i. Housing. I agree to thoroughly investigate housing costs, the suitability of the area e. Sponsorship. With the exception of Trainees/Interns working for InterExchange as
and living conditions of housing during my Training/Internship program, and the mode described in Section 5(d), I agree that InterExchange’s sole function is to Sponsor my
of transportation that I will be required to take. I must not wire money to unknown J-1 Visa and monitor my placement to ensure my safety and well-being throughout my
sources. I shall take responsibility for fully understanding the terms and conditions of Program.
any leases that I sign, including, without limitation, the duration of the lease and any 6. Air Travel & Transportation. I am solely responsible for all costs concerning air travel and
penalties for breaking the lease. transportation arrangements.
j. English Language Proficiency I certify that I have the ability to communicate 7. Safety, Emergencies & Problems
proficiently in English. I understand that I will be subject to English language a. Precautions.
screening, and I must complete an interview in English. I must possess English language
(i) I am responsible for my personal health and safety needs while participating in
skills sufficient to meet the goals of my Training/Internship Placement Plan and to
the Career Training USA Program. If I suffer from any health or other condition
understand and exercise my rights within the U.S.
that would create a risk to others or myself, I must not apply to or participate in
k. Sufficient Funds. I must provide proof of sufficient funds to support my Dependents the Program.
and myself throughout the duration of the Program. I understand that the funds must
(ii) I must take reasonable precautions to prevent injury or harm to others or myself,
be sufficient for the cost of living in the geographic location of my Training or Internship
or damage to the property of others or myself.
position and agree to research whether I have sufficient funds in advance of my arrival
into the United States. (iii) I am hereby provided notice that I am required to investigate to determine whether
my intended housing is safe and suitable (e.g., meet local safety code standards),
l. Insurance.
and I must demonstrate that my housing is safe and suitable if InterExchange
(i) I agree to the terms and conditions of the Insurance policy arranged through the requests said evidence from me. For more information regarding the suitability of
vendor authorized by InterExchange. I understand that InterExchange requires housing, I must read the information provided at the following link under Housing:
that I receive the Insurance policy through the authorized vendor for the purpose
http://www.interexchange.org/career-training-usa/internship-co-op-trainee-
of meeting or exceeding the U.S. Department of State Regulations as found in
job/resources
22 CFR Subpart A. I further understand that the Insurance coverage is not
comprehensive. In compliance with the Supplemental Insurance clause below, (iv) I must use safe and suitable transportation.
I understand it is my responsibility to maintain any additional Insurance that b. I agree to the following:
I may need. In addition, I understand that InterExchange is neither a seller nor (i) I must notify InterExchange in the manner required under this Agreement if I
reseller of Insurance. For additional information about the Insurance policy from experience any serious medical, psychological, or criminal incident.
InterExchange, I agree that I must read the terms and conditions of the policy in
the brochure and literature sent to me by InterExchange and visit InterExchange’s (ii) I must contact InterExchange immediately if the Host Employer endangers my
web site documentation about the policy located on the following web page: safety or the safety of others or acts in a manner that raises questions about my
safety or the safety of others.
http://www.interexchange.org/career-training-usa/internship-co-op-trainee-
job/resources (iii) To the extent that it is reasonably possible, I must stay in contact with
InterExchange Program representatives during any natural disaster or emergency.
I understand that InterExchange reserves the right to change Insurance provider If I am unable to contact or respond to InterExchange during a natural disaster
with or without notice at any time during my Program. or emergency, I must contact an authorized InterExchange representative to
(ii) Insurance Coverage Dates. I understand the importance of having Insurance confirm my circumstances as soon as it is reasonably feasible to do so.
coverage for the duration of my Program and my stay in the U.S. If I arrive or plan (iv) I must act as the point of contact between InterExchange and my J-2 Dependents
to arrive in the U.S. before the Program start date, I must make the arrival date (if applicable) during any natural disaster or emergency. I must also act as the
known to InterExchange in writing (e.g., via e-mail) immediately. I understand that point of contact for the purpose of emergency contact as described below under
a failure to notify InterExchange may result in a lack of coverage during my stay Emergency Contact, and I shall be responsible for ensuring the compliance of
in the U.S. I understand and agree that InterExchange may require that I purchase my Dependents with its terms. I understand that InterExchange may contact my
additional Insurance to cover early arrival dates. Pursuant to the Liability Section Dependents directly.
of this Agreement, I agree that InterExchange cannot be held responsible for any
claim made outside of the Insurance dates. (v) Emergency Messaging. In addition to following any emergency plan available to
me from local authorities or the Host Employer, if I supplied my mobile number,
(i) Supplemental Insurance. I understand that InterExchange’s involvement in my I agree to follow suggestions as may be sent through InterExchange emergency
Insurance coverage is limited to InterExchange’s determination that the approved messaging, including, without limitation, emergency texts from InterExchange.
or authorized policy complies with U.S. Department of State Regulations for If local authorities or the Host Employer recommend actions that conflict with
accident and medical sickness Insurance. I understand that the approved policy any messages sent via InterExchange emergency messaging, I shall follow the
may contain exclusions and may not cover pre-existing conditions. I agree to direction of the Host Employer or local authorities, as they may be better aware of
investigate my policy, and InterExchange strongly recommends, that I obtain local circumstances. I understand and agree that InterExchange is not obligated
supplemental insurance to meet any medical and travel coverage needs not met to provide me emergency messaging and that this is an additional service that
by the Insurance referenced herein for the duration of the Program. If the Host InterExchange may provide to me as circumstances may permit or warrant.
Employer promises to provide me with coverage to supplement Insurance, and
the Host Employer later denies me coverage during my Program with the Host c. InterExchange may take action regarding my health and safety
Employer, I agree to provide written notice to InterExchange of the changes. (i) In circumstances involving my health and safety, I agree that InterExchange may
m. Worker’s Compensation & Insurance. Unless otherwise stated in writing by the discuss my circumstances with the Host Employer, emergency contacts, the
Host Employer, I understand that the Host Employer will provide me with Worker’s International Cooperator, my Insurance company, healthcare officials, or any
Compensation coverage for the duration of my Program with the Host Employer. If the other critical party.
Host Employer is exempt from Worker’s Compensation coverage, the Host Employer (ii) I agree that InterExchange, its officers, employees, independent contractors,
will make me aware of its exemption. If the Host Employer changes my Worker’s vendors affiliates, and agents or any representative authorized by InterExchange
Compensation coverage during the Program, I agree to contact InterExchange may, without liability, or expense to themselves (as explained in further detail
in writing to provide notice. I am also under a duty to provide written notice to under the Warranties, Indemnification, Limitation of Liabilities, Release and Acts
InterExchange about any other changes to insurance coverage offered by the Host of God Section), take whatever action they deem appropriate with regard to my
Employer to me about which the Host Employer provides me notice. health and safety and may place me in a hospital or health-related facility for
n. Changes to Regulations and Requirements. I understand that there may be changes medical services, observation and treatment or, if no hospital or health-related
that apply to my Sponsorship. I agree to follow guidance from authorized InterExchange facility is readily available, may place me in the care of a local medical doctor or
representatives regarding these changes that may be communicated to me through health provider for treatment, observation or services.
including, without limitation, E-mail, the InterExchange web site, and Social Media. d. InterExchange Health and Safety
o. Completion of Intern/Trainee J-1 Visa Program. I agree to the following: (i) I understand that in the event of an accident or serious illness that, in the judgment
(i) No Training/Internship. I must not continue to train or intern with my Host of InterExchange, prevents me from successfully complying with the terms and
Employer during the 30-Day Travel/Grace Period. conditions of my Training/Internship Placement Plan, I will end the Program early
and return home at my own expense.
(ii) I must leave the U.S. on or before the end of my 30-Day Travel/Grace Period. If an
earlier date is indicated by Customs and Border Protection on my I-94 card than (ii) If InterExchange finds that I am subject to exploitative or other unreasonable
the date ending my 30-Day Travel/Grace Period, I must leave on or before the circumstances or conditions by my Host Employer, InterExchange, at
date indicated on the I-94 card. InterExchange’s sole judgment, may immediately withdraw its Sponsorship of
my Training/Intern position. I understand that InterExchange will seek to assist
(iii) When the Program ends, I must return the DS-2019 Form to InterExchange after I me with finding a new Training/Intern placement under which InterExchange can
return to my home country. provide Sponsorship, but that InterExchange cannot guarantee that I will receive
(iv) Evaluation Forms. My Host Employer and I must complete the following Evaluation a new position.
Forms provided by InterExchange, including the details of my participation in (iii) I agree that InterExchange has the right to dismiss me from the Program, if,
Cultural Exchange Events: in InterExchange’s sole judgment, I am deemed to be a danger to myself or to
(a) Interim Evaluation Form (if Program is six (6) months or longer). others, or if my conduct is deemed to be detrimental to the Program in anyway.
(b) Final Evaluation Form (for all Program lengths). e. Emergency instructions
5. Sponsorship and Employment (i) I must become aware of emergency plans set up by the Host Employer and as
a. At Will Employment Notice. I understand that the Host Employer’s Training/Internship issued by local authorities.
position is At-Will Employment. (ii) In case of emergencies (e.g., hurricanes, flooding, earthquakes, fires, terrorist
b. No Additional Employment. I must not work in any additional position, including, attacks), I agree to follow guidance issued by InterExchange, the Host Employer
without limitation, volunteer or paid employment, or internships, during the Program. I and local authorities. I agree to follow the guidance of the Host Employer and/or
must only work with the Host Employer that has been approved by InterExchange for local authorities if the guidance conflicts with InterExchange guidance.
the duration of my Sponsorship. f. Withdrawal. I must notify InterExchange if I decide to leave the Program for any
c. Changes in Employment. I agree to make InterExchange aware of any changes in my reason.
employment, including, without limitation, outsourcing my employment to third parties 8. Extensions and Change of Host Employer
such as employment agencies or consultants, changes in my supervision that impact a. Extension. I must meet the following conditions before I may be considered for an
my Training Plan, and other significant changes with my Host Employer of which I Extension:
become aware.

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 CAREER TRAINING USA Intern/Trainee Application

(i) Application. I must submit an Extension Application thirty (30) to sixty (60) days (ii) Within 10 days of any changes in address, telephone number, or email address
prior to the original Program end date as indicated on the DS-2019 Form. If it is that differs from the information that I provided to InterExchange for SEVIS.
less than thirty (30) days until the end of my Program, I cannot be considered for (iii) Any trips that I plan to take outside the USA. I also understand that I must have
an Extension. InterExchange sign my DS-2019 Form prior to taking a trip outside the USA and
(ii) Full Payment. My Extension Application must include full payment as outlined that the signature is valid for six (6) months only.
in the Career Training USA Extension Fee and Refund Schedule, which shall (iv) My Training/Internship Program ends or if I leave my Host Employer for any
be determined by the schedule then in effect at the time when the complete reason.
Extension Application is submitted for review to InterExchange Career Training
(v) I have been hospitalized or if I have been afflicted with a medical or mental
USA.
health condition that temporarily suspends or will not permit me to complete my
(iii) Insurance. I must maintain Insurance coverage under the terms and conditions Program.
described in this Agreement. I understand that the cost of Insurance is included in
(vi) I have been arrested or have been a victim or perpetrator of a crime while
my Program Fees when InterExchange extends my Program.
participating in the Program.
(iv) No Guarantee of J-1 Visa Approval. I understand that approval by InterExchange
11. Release, Intellectual Property, Social Media & Disrepute
is not an Extension of my J-1 Visa. My J-1 Visa may expire during the dates covered
by the Extension. If I travel outside of the USA after my Visa expires, I will have to a. Release
go back to the U.S. Embassy/Consulate in my home country and apply for a new (i) I give permission to InterExchange to (i) take and retain any photographs
J-1 Visa. The extended DS-2019 Form does not allow me to re-enter the United (including group photos), copies of images from passports, videos, audio
States if my visa has expired. recordings and other depictions of me (collectively, the “Reproductions”)
(v) Return Home. Upon completion of my Extension, I must depart the U.S. on or during activities associated with InterExchange; (ii) retain any Reproductions
before the end of the Extension Program 30-Day Travel/Grace Period. that I submit to InterExchange, or that I post on any InterExchange-branded or
InterExchange-affiliated media site, social networking site or video upload site
b. Early Termination from Training/Internship Position. If my Training/Internship
or “channel” or blog, including, without limitation, Facebook, LinkedIn, YouTube,
position ends early, I agree to the following procedure:
Twitter, or any other electronic site; and (iii) publish, distribute and display,
(i) If I am fired or I quit my Training/Internship position, I must notify InterExchange either in whole or in part, any Reproductions in any and all media throughout the
no later than ten (10) days after the termination of my employment. world, including, without limitation, media sites, social networking sites, video
(ii) Subject to InterExchange’s discretion and upon submission of applicable fees and upload sites or “channels,” blogs, electronic postings, calendars, brochures,
a Change of Host Application, I may seek a new Training/Internship Program and advertisements and other promotional materials.
my new Host Employer may submit a Training/Internship Placement Plan and (ii) I hereby waive compensation and any right to inspect or approve any such uses
other required employment documents. I understand that the length of the time and Reproductions. I must not submit any Reproduction unless I first obtained
for my new Internship/Training with the new Host Employer shall match the time permission from each person whose name, image, voice, or likeness is included
that I have remaining in the Program, provided, however that I have not applied in the Reproduction, and each such person has granted me and InterExchange
for and obtained an Extension under the terms and conditions of this Agreement. all copyright and other intellectual property rights, including renewal rights,
(iii) I must not work with the new Host Employer unless and until InterExchange necessary to use the Reproduction and his or her name, image, voice and likeness
approves the Host Employer and Training Plan. in it. I hereby release, discharge and agree to hold InterExchange harmless from
c. Removal from Program any liability arising out of InterExchange’s use of the Reproductions, including
any blurring, distortion, alteration, optical illusion or use in composite form with
If the Host Employer or I terminate employment, I may be asked by InterExchange to
other works. I hereby assign all copyright and other intellectual property rights,
return to my home country.
including renewal rights, to InterExchange, in any materials produced that are the
9. Fees, Cancellations, Expenses and Refunds subject of this Release.
a. Fees. I understand and agree to the fees in the applicable InterExchange Career b. Use of InterExchange Intellectual Property. If I desire to use InterExchange Intellectual
Training USA Fees Schedule, which shall hereby be incorporated into this Agreement Property for any reason, I must contact InterExchange’s Marketing Department to
in Exhibit C. I must confirm with InterExchange that I am filing my complete Application request permission. I must not use InterExchange’s Intellectual Property without
with the correct payment of fees based on the most up to date Career Training USA having obtained prior written permission. InterExchange Intellectual Property shall
Fees Schedule to avoid any delays due to a lack of full payment. include content from InterExchange’s Social Media, copyrights, trademarks, logos and
b. Emergency Messaging Fee. If I provide my mobile number for emergency contact any content owned by InterExchange. When in doubt, I understand the best policy is to
(e.g., emergency texting) from InterExchange, I agree to assume all necessary charges contact InterExchange to confirm that my use of intellectual property is acceptable to
per carrier fees for usage that may arise if InterExchange sends emergency messaging InterExchange.
to me. c. Disrepute. I must not act in a manner that brings InterExchange, the Exchange Visitor
c. Copies, Replacements or New Documents Fees. Program or the State Department into notoriety or disrepute
(i) If I am denied a visa and I wish to reapply at the Embassy/Consulate and require d. Social Media Policy. By signing this Agreement, I agree to the terms and conditions of
a new DS-2019 Form reflecting revised Program dates, I agree to the cost of a the Participant Social Media Policy set forth under the document labeled “Participant
reprint as indicated by the Career Training USA Program Fees. Social Media Policy,” which is located in the Career Training USA Resource Center at the
(ii) I understand that the DS-2019 Form is a controlled document that I must hold in following URL:
my possession throughout my Program, and, therefore, I shall bear the cost of http://www.interexchange.org/career-training-usa/internship-co-op-trainee-job/
replacing the DS-2019 Form if lost. resources
(iii) I agree that InterExchange cannot replace any other document, including, without 12. Privacy and Background Check
limitation, my visa, passport or I-94. Therefore, I am responsible for replacing any a. Privacy.
document that is not the DS-2019.
(v) InterExchange Privacy Policy. By signing below, I accept and agree to be bound by
d. Insurance Fee. I understand that the cost of Insurance provided by the authorized- InterExchange’s Privacy Policy pursuant to InterExchange's Terms of Use located
vendor under this Agreement is included in the Program Fee. at www.InterExchange.org/terms-use (link also located in the Career Training
e. Invoice. I agree that I will only receive an invoice upon my request for an invoice. USA Resources Center), its Privacy Policy located at www.InterExchange.org/
f. Refund Policy. I agree to the refund policy as outlined within the applicable Career privacy-policy (link also located in Career Training USA Resources Center), my
Training USA Program Fee Schedule. Application and the terms and conditions set forth in this Agreement. I agree that
I read each of these documents, which (if applicable) are incorporated herein by
this reference, as they form a legal agreement between InterExchange and myself
g. Additional Costs. I agree that InterExchange cannot be held responsible for any regarding the Privacy Policy of the Program. I understand that in the event of
additional costs to me due to, without limitation, delays in submitting documentation any conflict between the Application, this Agreement and those of the Terms of
or delays by the U.S. embassy in issuing a visa. Moreover, InterExchange strongly Use and Privacy Policy, the Terms of Use and Privacy Policy shall supersede with
advises that I not to book a flight or sign a lease until I secure my visa, since regard to the Privacy Policy.
InterExchange cannot be held responsible for the cost of rebooking or cancelling a (vi) Participants’ duty to provide privacy. In addition to the specific requirement for
flight or renegotiating lease terms with landlords due to delays in processing or visa Social Media listed under this Agreement, I agree to protect the privacy of any
rejections. party in a relationship with InterExchange and/or Career Training USA, including,
h. Visa Fees. I must pay the local visa fee to the U.S. Embassy. I am responsible for any without limitation, InterExchange staff. If I have questions about my duties
additional visa fees that might apply at the U.S. Embassy or the U.S. Consulate in the under this clause of the Agreement, I shall contact an authorized InterExchange
country where I am applying for the visa. manager for guidance.
10. Communication and Notice b. Background Information.
a. I must direct all electronic communication to InterExchange at training@interexchange. (vii) InterExchange. I agree that the Background Information Notice is incorporated
org. I must include the above email address in my e-mail address book to ensure receipt into this Agreement in Exhibit B. The Background Information Usage Notice
of communications from InterExchange. In the case of an emergency, I agree to contact authorizes InterExchange to use background information (e.g., police reports
InterExchange as soon as reasonably possible. and references obtained by me) for the purpose of determining my suitability
b. InterExchange will contact me at the email address that I provided in the InterExchange for the Career Training USA Program. By signing this Agreement, I certify
Career Training USA Application. I agree to respond to communications from that I understand and agree to the purpose for which InterExchange uses the
InterExchange in a timely manner. background information. By signing this Agreement, I further certify that I agree
to the methods by which InterExchange procures the background information.
c. I am responsible for acting as the point of contact for Dependents, but I understand
that InterExchange may contact my Dependents as necessary throughout the duration (viii) Host Employer. I understand and agree that the Host Employer may request
of the Program. additional screening of me at the Host Employer’s own expense, and that
InterExchange is not responsible for any actions taken by the Host Employer. I
d. Emergency Messaging. For the purpose of emergency messaging, I agree that
understand that the Host Employer must conduct such investigation pursuant to
InterExchange may contact me via text message and/or voice services through my
the laws of the U.S. and state and local laws in which the Host Employer conduct
mobile phone and/or by email.
its business.
e. Specific Circumstances Requiring Notice. In addition to the general notice
13. Additional Agreement Terms
requirements set forth under this Agreement, I must provide notice to InterExchange
under the following circumstances: a. Entire Agreement. I understand that this Agreement contains the entire understanding
of the parties with respect to the matters contained herein and supersedes any
(i) SEVIS Reporting. Within ten (10) days of arrival into the U.S, I must provide
previous agreements (oral, written or otherwise) and may be altered or amended only
InterExchange with my address, telephone number, and e-mail address for the
by a written instrument duly executed by both parties hereto.
purpose of registering into SEVIS. I understand that the consequences of not
reporting to SEVIS may include, without limitation, InterExchange ending my b. Incorporated Documents. I understand and agree that 22 CFR 62 (Exchange Visitor
Program or the U.S. Department of State detaining and/or deporting me for Program Regulations), the Wilberforce Brochure (if applicable and see also “Dispute
immigration violations. Process”) as located on InterExchange’s website located at http://www.interexchange.
org/career-training-usa/internship-co-op-trainee-job/resources, and the Extension

CT–PA01–1212 Page 13 of 17
 CAREER TRAINING USA Intern/Trainee Application

Term Sheet (if applicable and as described in this Agreement) are incorporated into contractual relationship for all personal debts including without limitation, phone
this Agreement. With regard to the use of InterExchange’s website located at www. calls and gym memberships.
InterExchange.org (“Site”), I understand and agree that I must follow terms and (ii) Transportation. I agree not to hold InterExchange, its officers, affiliates,
conditions of www.InterExchange.org/terms-use and www.InterExchange.org/ independent contractors, agents and employees liable for arranging transportation
privacy-policy, which are incorporated into this Agreement for the purpose of Privacy in the Program, and I agree not to hold any of them liable in connection with
Policy and site use only rather than for the general terms and conditions of the Program. any loss, damage, personal injury, delay or expense suffered or incurred by me,
Unless required by law or regulation (e.g., required 22 CFR Part 62, Wilberforce, the resulting from any act or omission of any carrier, the Host Employer or any other
Department of State or federal, state or foreign law) or involving InterExchange’s body, corporate or non-corporate entity, in relation to transportation to and from
Privacy Policy, if there is a conflict between this Agreement and other documents and within the United States, my duties as an Trainee/Intern or any other facility or
incorporated into this Agreement, the Agreement shall be controlling. service organized on my behalf.
c. Agreement in English. This Agreement and correspondence between InterExchange (iii) Specific Liabilities. I agree that I am responsible, and that I shall hold InterExchange
and myself shall be written in English. In the case of any disputes between the parties, as not liable or responsible for any claims, liability, damages or costs incurred
the language that shall govern interpreting this Agreement or any issue arising out of by reason of any breach, act, error, negligence or omission that arises out of or
communications, including, without limitation, correspondence, shall be English. concerns, without limitation, the following:
d. Assignment. This Agreement is restricted solely to myself and shall not be assigned, a. The performance of my duties as an Trainee or Intern
transferred, encumbered, or subject to any third party agreement without the written
b. Risks associated with any delay in my J-1 Visa Program that arise out of or
consent of InterExchange. Any attempted assignment will be void and of no effect.
concerns the DS-2019 Form.
InterExchange may assign this Agreement to a successor (whether by merger, a sale of
all or a significant portion of its assets, a sale of a controlling interest of the company or c. Decisions and actions carried out by the Host Employer
otherwise), which agrees in writing to assume InterExchange’s obligations under this d. Section 7(c)(i) and (ii), which respectively address InterExchange discussing
Agreement. health and safety circumstances with third parties and taking action on my
e. Waiver. I agree that InterExchange’s failure to enforce any provision of this Agreement behalf in case of health or safety emergencies. Although InterExchange may
shall not be construed as a waiver or limitation of InterExchange’s right to subsequently elect to act as set forth in Section 7(c)(i) and (ii), I agree that InterExchange is
enforce and compel strict compliance with each and every provision of this Agreement. not liable if InterExchange fails to act. I agree that neither Section 7(c)(i) and
(ii) nor any other term under the Agreement creates an affirmative duty, either
f. Void Provision. If any provision of this Agreement is held to be void or contrary to law,
expressed or implied, for InterExchange to act. In compliance with Section
I understand that such provision shall be construed as nearly as possible to reflect the
7(c)(i) and (ii), I agree that InterExchange is not liable for acting on my behalf
intention of the parties, with the other provisions remaining in full force and effect.
under the circumstances described in Section 7(c)(i) and (ii).
g. Headings. I agree that all headings are for purposes of convenience only and are not
e. Obtain housing as required under the terms and conditions of this Agreement
to be used in interpretation or enforcement of this Agreement. Terms defined in the
singular have the same meaning in the plural and vice versa. f. Insurance (including car insurance for vehicles) or medical, dental and health
care needs that I may have during the Program.
h. Third Parties. Unless otherwise expressly stated in this Agreement, I agree that the
terms and conditions of this Agreement, express or implied, exist only for the benefit g. Any exclusions not covered by my Insurance or car insurance
of the parties to this Agreement. No other person or entity will be deemed to be a third h. My failure to meet immigration status requirements while in Program (e.g.,
party beneficiary of this Agreement. Any contracts that are required by any party other travel outside of U.S. with expired J-1 Visa)
than InterExchange are signed at my own risk as a Participant and are agreements i. My failure to follow emergency and safety rules suggested or required by
between the Third Party and me for which InterExchange is not liable. InterExchange, the Host Employer or local authorities
i. Prior Agreements. Any prior agreement between Participant and InterExchange j. My disclosure of information and/or documents to unauthorized parties (e.g.,
is hereby amended by this Agreement, and, as between this Agreement and the tax payer ID number or passport)
prior agreement, this Agreement shall be controlling between the parties. The prior
Agreement shall remain in effect if prior terms do not conflict with this Agreement. k. My failure to apply for and obtain necessary documentation and information
as described in this Agreement
j. Change of Sponsor. I understand and agree that InterExchange does not facilitate
a request to change sponsors during the Program. I understand and agree that if I l. Inadvertent disclosure to third parties in the course of conducting an
terminate this Agreement or otherwise end my Program that I am to return to my home investigation involving my well-being or suitability for the Program.
country rather than stay in the U.S. m. Breaching any other term of this Agreement (e.g., failure to follow laws of the
14. Laws, Regulations and Culture U.S. or guidance from states and local authorities).
a. U.S. State Department Regulations. I acknowledge and agree that I am participating in n. Errors in Application, government required forms (e.g., DS-2019 Form), SEVIS
a Cultural Exchange Program and agree to comply with all of the Regulations published information, and biographical information.
by U. S. Department of State 22 CFR Sec. 62, which may be amended from time to g. Act of God. I agree that InterExchange and/or its officers, employees,
time in the future. I further agree to meet my obligation regarding SEVIS compliance independent contractors, and agents are neither responsible nor liable for any
and the accuracy of the information that I provide as required by the Regulations and events beyond their control, including, without limitation, Government restrictions
in compliance with the terms of this Agreement. I acknowledge receipt of a copy of 22 that may interfere with or preclude operation of the Program; any events directly
CFR Sec. 62.22, which can be viewed at the following URL: or indirectly caused by any intentional or negligent acts or omissions by the
http://www.interexchange.org/career-training-usa/internship-co-op-trainee-job/ Host Employer or those with whom I come into contact as a consequence of
resources participating in the Program; the necessity of returning me to my home country
early or ending my Program early due to health reasons, transportation (e.g., air
b. I must comply with federal, state, and local laws of the U.S., including income tax filing travel); terrorism; wars; and natural disasters.
requirements. I am responsible for reading and carefully considering all materials made
available to me that relate to safety, health, legal, environmental, political, culture and h. Indemnification. I shall indemnify, without limitation, InterExchange, its officers,
religious customs and conditions in the U.S. employees, agents, independent contractors, and organizations affiliated with
InterExchange, against any loss or damage suffered by any of them, or any
c. I understand InterExchange’s notice that I am considered a non-resident alien who claims made against any of them as a result of any breach, act, error, omission or
is not subject to Social Security (FICA), Medicare, or federal unemployment (FUTA) negligence by me during my participation in the Program and for the duration of
withholding taxes. I understand that this information is provided for notice only. my stay in the U.S.
d. I must comply with all of InterExchange’s polices, rules, and procedures, as outlined in 16. Disputes
this Agreement, the InterExchange website, and any further documents, materials, and
communications that I may receive from InterExchange with regard to my participation a. Complaints Procedure. I and concerned third parties have the right to contact
and obligations for this J-1 Intern/Trainee Visa Program the U.S. Department of State regarding any serious allegation arising under the
Wilberforce Anti-trafficking requirement as set forth in the Wilberforce brochure that
15. Warranties, Indemnification, Limitation of Liabilities, Release and Acts of God. I received from InterExchange or upon refusal of InterExchange to address claims. I
a. No Guarantee of Training/Internship or Participation. I agree that InterExchange does also understand that InterExchange will investigate allegations about my progress,
not guarantee a Training or Internship position with any Host Employer or participation well-being and suitability in the Program as directed by management of the Bureau
in the Program. of Educational Cultural Affairs. I understand that InterExchange will not divulge any
b. No Guarantee of Satisfaction or Suitability. I agree that InterExchange does not background information about me other than the information required to respond to
guarantee satisfaction or suitability with the Program, the Training or Internship the request for investigation.
position, Host Employer, or the cultural exchange experience of living in the U.S. b. In the event that I wish to lodge a complaint about any services provided by
c. Information Provided “As Is” Without Warranty or Guarantees. I agree that any InterExchange, its suppliers, agent, representatives, independent contractors, vendors
information (e.g., tax and labor law requirements and emergency information and and/or affiliates (e.g., Insurance vendor, Host Employer, International Cooperator,
plans) communicated by InterExchange to me is provided “as is” without warranties or or anyone in a relationship with InterExchange), I must first notify an authorized
guarantees either expressed or implied that information is “up to date”, correct and/or InterExchange manager in writing in order to give InterExchange the chance to rectify
accurate. the problem.
d. Participant General Liability. I waive and release InterExchange from any and all claims c. I understand and agree the laws of the state of New York govern this Agreement.
for contract damages, torts arising out of or concerning my employment with the Host d. I agree that any controversy, dispute or claim arising out of or in connection with
Employer and any liability that I incur that arise out of or concerning my participation in this Agreement, the relationship of the parties, or its interpretation, performance
the Program, including, without limitation, any lost, stolen or damaged property and/ or nonperformance, or any breach thereof shall be determined solely in arbitration
or any bodily injuries that harms a third party or me. conducted in New York City in accordance with the then existing rules of the American
e. Limitation of Liability. If a court, government agency or legal authority finds that Arbitration Association.
InterExchange has a duty under foreign or U.S. federal, state or local law, I understand e. Cost of Arbitration. In the event of arbitration as described in 16(d), I understand and
and agree that InterExchange’s liability (if any) shall be no greater than its role as a agree that the non-prevailing party must reimburse the substantially prevailing party
nonprofit sponsor under the U.S Department of State regulations. I agree that nothing for all reasonable attorneys’ fees, expenses incurred in bringing or defending the action
herein described in this paragraph or in the Agreement creates a duty or obligation and costs resulting or arising out the litigation.
under the law, and that the language written herein is provided solely for the purpose f. Cost of Litigation. In the event that a court or legal authority fails to enforce the
of limiting liability to InterExchange’s role as my Sponsor. I further agree that arbitration clause set forth in 16(d), I understand and agree that the non-prevailing
InterExchange’s liability is subject to the limitations set forth in separate paragraphs party shall reimburse the substantially prevailing party for all reasonable attorneys’
described in Section 15. fees, expenses incurred in bringing or defending the action and costs resulting or
f. Specific Liability. arising out the litigation.
(i) Expenses. I am responsible for all my personal debts, including, without limitation, 17. Term and Termination
phone calls, rent, gym memberships, medical expenses, and Insurance co-pay a. This Agreement shall be effective as of the submission of any part of the Application
or uncovered exclusions. I agree that InterExchange shall not be liable for any (the “Effective Date”). The Agreement shall automatically terminate upon the
personal bills incurred by me during the Program. I agree that I am responsible completion of the Program and departure of Dependents and myself from the United
directly to the Host Employer or other third parties with whom I have established a States.

CT–PA01–1212 Page 14 of 17
 CAREER TRAINING USA Intern/Trainee Application

b. Either party may terminate this Agreement at any time. Either party may terminate this EXHIBIT A
Agreement immediately in the case of serious breach by a party as solely determined
by the party claiming such breach, which has not been remedied within one month Extension Terms & Conditions
after a substantiated, written request has been sent to the breaching party. I agree to the following additional terms and conditions of the Agreement if an Extension is
c. InterExchange is Sponsor designated by the U.S. Department of State of the Internship/ requested and granted:
Training J-1 Visa Program and InterExchange may at any time withdraw my Sponsorship 1. Duration. I (and my Dependents, if applicable) understand that the duration of an
for any reason including, but not limited to criminal conduct, mental illness, discovery Extension is the difference between the total time allotted under the U.S. Department
of fraudulent information submitted in my Application, non-compliance with Program of State Regulations for a Trainee or Intern Program minus the time already used by a
Regulations (22 CFR Part 62.22), or InterExchange’s program rules and policies, or due Trainee or Intern (e.g., if an Intern completes a four (4) month Program, the Intern may
to any deviation from the Training/Internship Plan (Form DS-7002) that is not in line extend a maximum duration of eight (8) months because the total time allotted under
with program regulations and InterExchange’s program rules and polices. In the event the U.S. Department of State Regulations is twelve (12) months).
of my Sponsorship ending, this Agreement shall terminate effective upon the date of
status change within SEVIS. 2. Extension Training/Internship Plan. I understand and agree that the Extension
Training/Internship Plan must describe new tasks and goals and must focus on
d. I understand and agree that if I leave the U.S. for more than 30 days that my Sponsorship additional skills that will be acquired during the Extension period.
shall end and this Agreement shall automatically terminate.
3. Final Evaluations. The Host Employer and I must submit Final Evaluations from my
e. Survivorship. I agree that the terms and conditions regarding definitions, liability, fees, original Training/Internship Program before InterExchange will review my Extension
privacy, releases, intellectual property, Social Media, reputation, confidentiality and Application.
expenses/costs shall survive the termination of this Agreement
4. Change of Host Employer. If I change my Host Employer for the Extension period,
18. Full Disclosure. I agree that I am solely responsible for the accuracy and full disclosure of the new Host Employer must complete a Host Employer Application and provide all
any information provided my dependents, myself or a Third Party representing us and agree the required documentation, as indicated on the Application Checklist. If my new
to keep information accurate and up to date. I confirm that the information that I provided is Host Employer is not eligible to participate, I may select another new Host Employer
true, complete and accurate, and upon request I will provide any additional documentation or remain with my current Host Employer for the Extension period. However, all of
necessary to participate in this Program. these details must be finalized 30 to 60 days prior to the original Program end date as
19. Dependents. I understand that I am permitted to bring Dependents with me under the indicated on my DS-2019 Form.
Program as J-2 Visa holders. J-2 Visa Dependents may be a spouse and/or unmarried 5. Updated DS-2019. If my Extension Application is approved, InterExchange will issue
children under the age of 21. J-2 Visa Dependents must be approved by InterExchange, an updated DS-2019 Form, which will cover the Extension period. I must keep the new
which is the Sponsor of the Dependent. If a Dependent is a Minor Child Dependent, I hereby DS-2019 along with my original DS-2019 Form, J-1 Visa and I-94 card. An approved
certify that I have the authority to act as the legal guardian of the Minor Child Dependent, Extension means that I am legally permitted to remain at my Training or Internship
to sign agreements for the Minor Child Dependent, and otherwise to act on behalf of the position in the United States for the duration of my status, as indicated by the dates on
Minor Child Dependent during their stay in the U.S. and participation in the Program, and I my new DS-2019 Form.
agree to ensure the Minor Child Dependent’s compliance with the rules and Regulations of
the Program, the terms and conditions of this Agreement, and U.S. federal, state, and local 6. J-1 Visa. An Extension approval from InterExchange is NOT an extension of my J-1 Visa.
laws. If Dependent is an Adult Dependent, I understand that the Adult Dependent must My J-1 Visa will still expire according to the date listed on the visa. If I travel outside
sign a separate agreement that states (a) that the Adult Dependent must comply with the the USA after my visa expires, I must return to the U.S. Embassy/Consulate in my home
rules and Regulations of the Program, the terms and condition of this Agreement, and U.S. country to apply for a new J-1 (or J-2 Visa as pertains to Dependents) that may or may
federal, state and local laws; and (b) sets forth additional terms and conditions applicable not be granted. The extended DS-2019 Form does not allow my Dependents or me to
to the Adult Dependent. Except for the rules and Regulations specifically defining the J-1 enter the United States if my/our visas have expired.
Visa holder’s Internship or Training, Dependents and I agree that the terms and conditions 7. Evaluation. If the Extension is less than six (6) months, I must complete an Extension
of this Agreement shall generally be applicable to Dependents. Dependents and I further Final Evaluation Form at the end of my program. If the Extension is more than 6
agree that InterExchange shall make the final determination during the administration of months, I must complete both an Extension Interim and Final Evaluation Form.
the Program about which terms and conditions under the Agreement that are applicable to
Dependents.
20. Signature EXHIBIT B
a. This Agreement may be signed in counterparts and by scan/email, each of which will
Background Information Notice
be deemed an original and both of which together will constitute one agreement.
1. I understand this Notice provides further communication to ensure my awareness of
b. I, the undersigned, confirm that I have read, fully understand, accept and agree to be
why and how background information is used by InterExchange.
bound by all terms and conditions set forth in this Agreement and that the information
I have provided is true, accurate and complete. 2. I understand that any background information, including, without limitation, health
information, school records and personal identifying information is gathered by me as
required in my Application or separate writing to be delivered to InterExchange for the
INTEREXCHANGE purpose of determining my suitability for the Program and the purposes described in
InterExchange’s Privacy Policy and its Terms of Use.
Signature������������������������������������������������������������������������ 3. I certify that I agreed to assist InterExchange by signing the Agreement and submitting
the background information requested.
Print Name_______________________________________________________________________ 4. If InterExchange should require additional background information, I understand that
this Notice shall remain in effect for the duration of my association with InterExchange.
5. Pursuant to the Agreement, I release InterExchange and any and all persons,
InterExchange’s Title_______________________________________________________________
independent contractors and parties with whom InterExchange maintains a contractual
relationship (e.g., International Cooperators) and governmental agencies (e.g., U.S.
Department of State), whether public or private, from any and all liability, claims and/
PARTICIPANT or demands, by me, my heirs or others making such claims or demands on my behalf,
that arise out of or pertains to the background information and/or any investigative
report based on background information.
Signature________________________________________________________________________ 6. If I have questions about the background information and any reports derived from the
background information, I agree to contact InterExchange management. I understand
Print Name_______________________________________________________________________ that I am entitled to a complete and accurate disclosure of the nature and scope of
any investigation into my background upon written request to InterExchange. I agree
to make requests before the completion of the Program, or not longer than 12 months
after submitting background information, whichever is shorter.

CT–PA01–1212 Page 15 of 17
 CAREER TRAINING USA Intern/Trainee Application

INTEREXCHANGE, INC.
Career Training USA
J-2 Dependent Visa Sponsorship Agreement
This J-2 Dependent Visa Sponsorship Agreement (‘”Agreement”) by and between InterExchange, Inc., a 501(c) (3) organization located at 161 Sixth
Avenue, New York, NY 10013 (“InterExchange”), and myself, a J-2 Visa Dependent, (herein “Dependent”) defines the terms and conditions between
InterExchange and myself regarding InterExchange’s Sponsorship of my J-2 Visa for the Cultural Exchange Program involving professional training
of the Participant, who separately has signed and agreed to the terms and conditions of the Program under the Career Training USA J-1 Participant
Agreement (“Participant Agreement”)

BACKGROUND b. Specific Liability. In addition to the specific liabilities included in the Participant
Agreement I understand that are each applicable to me, I understand and agree:
InterExchange is a designated Sponsor of the Career Training USA J-1 Visa Program administered 10. Fees. In compliance the Participant Agreement and this Agreement, I agree to pay all Fees
by the U.S. Department of State’s Bureau of Educational and Cultural Affairs (the “Program”). and comply with all policies regarding Fees, Cancellations, and Refunds as set forth in
The Program allows qualified Participants to enter the United States as an Intern or Trainee the Participant Agreement and the applicable Fee Schedule attached to the Participant
so that the Participant may increase their understanding of American culture and society Agreement.
and enhance the American Host Employer’s knowledge of foreign cultures through an open 11. Communication. In compliance the terms and conditions set forth in the Participant
interchange of ideas. Agreement, I agree to respond to InterExchange’s communication with me during the
This Career Training USA Program allows Dependents to accompany qualified Trainee and Program.
Intern participants during their Program in the U.S. to enhance the Cultural Exchange exposure 12. Privacy and Background Information.
of Participants and Dependents. Dependents are defined under the Participant Agreement
as the spouse and/or children of J-1 Visa Participants sponsored by InterExchange under the a. Privacy.
J-2 Visa. For a more extensive view of the terms used in this Agreement, the Dependent must (i) InterExchange Privacy Policy. By signing below, I agree to be bound by
read the Definition section incorporated into the Participant Agreement. InterExchange’s InterExchange’s Privacy Policy pursuant to InterExchange's Terms of Use
Sponsorship of a J-2 Visa is dependent upon the J-1 Visa Sponsorship (e.g., if InterExchange located at www.InterExchange.org/terms-use, its Privacy Policy located at www.
ends the Sponsorship of the J-1 Visa holder so that the J-1 Visa holder must return home, the InterExchange.org/privacy-policy, my Application and the terms and conditions
Sponsorship of the J-2 Visa also ends). set forth in this Agreement. I agree that I read each of these documents, which
Agreement (if applicable) are incorporated herein by this reference, as they form a legal
agreement between InterExchange and myself regarding the Privacy Policy of the
Having read and understood the Participant Agreement and my role as a Dependent, I agree to Program. I understand that in the event of any conflict between the Application,
the following terms and conditions of this Agreement: this Agreement and those of the Terms of Use and Privacy Policy, the Terms of Use
and Privacy Policy shall supersede with regard to the Privacy Policy.
1. Bound by Participant Agreement. I agree to be bound by the terms and conditions of the (ii) Participants’ duty to provide privacy. In addition to the specific requirement for
Program generally applicable under the Participant Agreement. Except for terms defining Social Media listed under this Agreement, I agree to protect the privacy of any
the duration of the J-1 Visa holder’s Program (e.g., J-1 Visa Participant is fired or quits from party in a relationship with InterExchange and/or Career Training USA, including,
the Training/Internship position) or as stated in this Agreement, I understand that the terms without limitation, InterExchange staff. If I have questions about my duties under
and conditions about the Host Employer or employment in the Participant Agreement are this clause of the Agreement, I shall contact an authorized InterExchange manager
not applicable to me. If there is any ambiguity or issue raised concerning whether I am for guidance.
obligated to comply with a term of the Participant Agreement, I agree that InterExchange, b. Background Information.
at its sole discretion as Sponsor of my J-2 Visa, shall make final determination about my (iii) InterExchange. I agree that the Background Information Usage Notice is
compliance with the Participant Agreement. incorporated into this Agreement in Exhibit A. The Background Information
2. Effective Date. The Effective Date of this Agreement is the date upon which the J-1 Usage Notice authorizes InterExchange to use background information (e.g.,
Participant in the Program first submits an Application on my behalf. police reports and references obtained by me) for the purpose of determining
3. Complete Application. I agree that I am required to complete the Application. For the my suitability for the Career Training USA Program. By signing this Agreement,
purposes of this Agreement, the Application shall be considered complete upon the I certify that I understand and agree to the purpose for which InterExchange
Participant submitting accurate and complete information about me as required by uses the background information. By signing this Agreement, I further certify
InterExchange and Program rules and Regulations and in compliance with the terms and that I agree to the methods by which InterExchange procures the background
conditions of the Participant Agreement. information.
4. Different or Change of Sponsorship. In compliance with the terms of the Participant (iv) Host Employer. I understand and agree that the Host Employer may request
Agreement, I shall not change sponsors. additional screening of me at the Host Employer’s own expense, and that
InterExchange is not responsible for any actions taken by the Host Employer. I
5. Program. In compliance with the terms of this Agreement, I hereby agree to the following:
understand that the Host Employer must conduct such investigation pursuant to
a. I must maintain Insurance as required by the U.S. Department of State Regulations the laws of the U.S. and state and local laws in which the Host Employer conduct
throughout the length of my stay as a J-2 Dependent. its business.
b. I cannot come to the U.S. for any reason not arising out of or concerning my status as 13. Release. By signing the Agreement, I agree to the following:
a J-2 Dependent, including, without limitation, to seek medical treatment for myself or
a. I give permission to InterExchange to (i) take and retain any photographs (including
any children, or U.S. citizenship status for any unborn children.
group photos), copies of images from passports, videos, audio recordings and other
c. I understand that I am not required to remain in the U.S., and J-1 Visa holder cannot depictions of me (collectively, the “Reproductions”) during activities associated with
require that I stay in the U.S. If I depart the U.S. prior to the J-1 Visa Participant, I agree InterExchange; (ii) retain any Reproductions that I submit to InterExchange, or that
to notify InterExchange regarding my departure so that my status in SEVIS can be I post on any InterExchange-branded or InterExchange-affiliated media site, social
properly amended. networking site or video upload site or “channel” or blog, including, without limitation,
6. Minor Child Dependents. I agree that the terms of the Participant Agreement shall apply to Facebook, Linked-In, YouTube, Twitter, or any other electronic site; and (iii) publish,
all accompanying Minor Child Dependents described in the Career Training USA Participant distribute and display, either in whole or in part, any Reproductions in any and all media
Application for whom I am a legal guardian (e.g., parent) in conjunction with the J-1 throughout the world, including, without limitation, media sites, social networking
Participant, who must also maintain the status of legal guardian. sites, video upload sites or “channels,” blogs, electronic postings, calendars, brochures,
7. Employment. I understand that I may work as long as my income is supplemental to and not advertisements and other promotional materials.
necessary for the Participant to meet the Sufficient Funds requirement under the Participant b. I hereby waive compensation and any right to inspect or approve any such uses
Agreement and U.S. Department of State Regulations. I understand that InterExchange and Reproductions. I must not submit any Reproduction unless I first obtained
does not assist nor provide services regarding submitting an application for me to work permission from each person whose name, image, voice, or likeness is included in the
in the U.S. I understand and agree that InterExchange provides information regarding the Reproduction, and each such person has granted me and InterExchange all copyright
application process “as is” and without any warranty that said information is correct. I agree and other intellectual property rights, including renewal rights, necessary to use the
that InterExchange is in no way responsible for my obtaining work. I agree that any work I Reproduction and his or her name, image, voice and likeness in it.  I hereby release,
pursue must comply fully with American tax and labor laws and not bring InterExchange discharge and agree to hold InterExchange harmless from any liability arising out of
or the U.S. Department of State into notoriety or disrepute as in generally required under InterExchange’s use of the Reproductions, including any blurring, distortion, alteration,
the terms of this Agreement and the Participant Agreement. For more information about optical illusion or use in composite form with other works. I hereby assign all copyright
employment, I can investigate the subject by visiting the Career Training USA Resource and other intellectual property rights, including renewal rights, to InterExchange, in
Center located at the following URL: any materials produced that are the subject of this Release.
http://www.interexchange.org/career-training-usa/internship-co-op-trainee-job/resources 14. Full Disclosure. I am solely responsible for the accuracy and full disclosure of any information
From the Career Resources Center, I can click on the link labeled J-2 Dependent Employment provided by my representing agent, a legal guardian, the J-1 Participant or myself and agree
to keep it completely accurate and up to date. I confirm that the information I have provided
to find information offered by USCIS at its site.
is true, complete and accurate, and upon request I will provide any additional documentation
8. Final Decision. I understand that InterExchange is not required to act as my Sponsor for the necessary to participate in this Exchange Program.
J-2 Visa. I agree that InterExchange, at its sole discretion, makes the final decision about my
J-2 Sponsorship without regard to any decision made regarding the J-1 Participant. 15. Signature
9. Liability. In addition to agreeing to the terms and conditions regarding Warranties, a. This Agreement may be signed in counterparts and by scan/email, each of which will be
Indemnification, Limitation of Liabilities, Release and Acts of God found in the Participant deemed an original and both of which together will constitute one agreement.
Agreement, I agree to the following terms and conditions regarding my liability under the b. I, the undersigned, confirm that I have read, fully understand, accept and agree to be
Program: bound by all terms and conditions set forth in this Agreement and that the information
a. Assumption of Risk. I understand and agree that the main focus of the Career Training I have provided is true, accurate and complete.
USA Program is the Cultural Exchange of the Participant. I assume the risk regarding
my participation in the Program.

CT–PA01–1212 Page 16 of 17
 CAREER TRAINING USA Intern/Trainee Application

INTEREXCHANGE EXHIBIT A
Signature������������������������������������������������������������������������
BACKGROUND INFORMATION NOTICE
Print Name�����������������������������������������������������������������������
1. I understand this Notice provides further communication to ensure my awareness of why
and how background information is used by InterExchange.
InterExchange’s Title���������������������������������������������������������������
2. I understand that any background information, including, without limitation, health
information, school records and personal identifying information is gathered by me as
required in my Application or separate writing to be delivered to InterExchange for the
J-2 PARTICIPANT purpose of determining my suitability for the Program and the purposes described in
InterExchange’s Privacy Policy and its Terms of Use.
3. I certify that I agreed to assist InterExchange by signing the Agreement and submitting the
Signature������������������������������������������������������������������������
background information requested.
4. If InterExchange should require additional background information, I understand that this
Print Name����������������������������������������������������������������������� Notice shall remain in effect for the duration of my association with InterExchange.
5. Pursuant to the Agreement, I release InterExchange and any and all persons, independent
contractors and parties with whom InterExchange maintains a contractual relationship (e.g.,
International Cooperators) and governmental agencies (e.g., U.S. Department of State),
whether public or private, from any and all liability, claims and/or demands, by me, my heirs
or others making such claims or demands on my behalf, that arise out of or pertains to the
background information and/or any investigative report based on background information.
6. If I have questions about the background information and any reports derived from the
background information, I agree to contact InterExchange management. I understand
that I am entitled to a complete and accurate disclosure of the nature and scope of any
investigation into my background upon written request to InterExchange. I agree to
make requests before the completion of the Program, or not longer than 12 months after
submitting background information, whichever is shorter.

CT–PA01–1212 Page 17 of 17