Cordell Hull Foundation J-2 Dependent ROSTER FORM 2009

Be sure to spell name exactly as written on the passport.

Be sure to fill in all blank spaces.

Teacher's FULL NAME

U.S. State where teacher will work

DEPENDENT LAST NAME as written in PASSPORT

DEPENDENT FIRST NAME(S) as written in PASSPORT

DEPENDENT MIDDLE NAME(S) as written in PASSPORT

SEX

DATE OF BIRTH

 
Masculine   Feminine Relationship to teacher
(check one or the other)

City of Birth

Country of Birth

      SPOUSE
      CHILD
Country of Citizenship Country of Legal Residence  
 
Passport number Country of Passport Issuance  
Home address in country of origin
Contact phone no. in country of origin (preferably cell)

FAX to 646-349-3455 A COPY OF:  
NAME PAGE IN YOUR PASSPORT OF ALL DEPENDENTS

This CHF fax number is digital and does not require a coversheet.

If you have any questions, send an email to pro@cordellhull.org.  email is preferred over a telephone message.

Your input will be used to generate visa paperwork.  Remember that any mistake in spelling or numbers could result in refusal of a J-1 visa passport stamp by the American Embassy. Check your inputting carefully for typos or misspellings.     Thank you.

 
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