JEEP Application

Application for Semester

Partner Institution

Name (As it appears on your passport)

Last

First

Middle

Other name on supporting documents

Permanent Mailing Address (Foreign Address)

Street

City

State

Country

Postal Code

Phone Number

Email Address

Current Mailing Address

Street

City

State

Country

Postal Code

Phone Number

Email Address

Academic Interest

College

Major

Personal Information

Date of Birth

City of Birth

Country of Birth

Gender

Male

Female

Marital Status

Ethnic Background

Multi-Ethnic or Other

If Multi-Ethnic or Other, please specify:

Religious Preference

Primary Language Spoken at Home

Are you a U.S. Citizen

Yes

If no, what is your country of citizenship?

Country of Nationality

Visa Alternative Text

Most Jesuit Exchange Program applicants will apply for a J-1 (Exchange Visitor) Visa. If you plan on using a different non-immigrant visa, please list it below:

Have you ever been convicted of a criminal offense?

If yes, please explain

Have you been inside the U.S. within the preceding 12 months?

INS/US Department of State documents

(If yes, please note that you must provide, with this application, copies of all INS/US Department of State related documents in order to determine eligibility for J-1 status at USF. Send documentation to jeep@usfca.edu.)

US Visits

Please include dates of visit(s) and city or cities visited.

US Visit

Dates in U.S.

Immigrant Status

US Visit

Dates in U.S.

Immigrant Status

US Visit

Dates in U.S.

Immigrant Status

Previous J-1 Visa Status

DS-2019

If yes, please send copies of all previous DS-2019 forms to jeep@usfca.edu.

Academic Background

Universities Attended

Universities/Institutions Attended: (List all post-secondary [tertiary level] schools beginning with school currently or most recently attended)

University/Institution

Name

City/State/Telephone Number

Date Attended From

University/Institution

Name

City/State/Telephone Number

Date Attended From

University/Institution

Name

City/State/Telephone Number

Date Attended From

Emergency Contact/Family Information

Emergency Contact

Full Name

Relationship

Address

Phone Number

Emergency Contact

Full Name

Relationship

Address

Phone Number

Siblings

Applicant's Siblings/Children (if any)

Sibling

Name

Relationship

Sibling

Name

Relationship

Sibling

Name

Relationship

If any of your relatives have attended/are attending USF, please list their names, relationship to you, and year of graduation

By checking this box, I hereby certify that all the information I provided on this JEEP Application Form is true and correct.