Untitled Document

Cordell Hull Foundation J-1 Exchange NEW PROGRAM APPLICATION To be completed by School, District or State Hull Foundation J 1 visa
Complete ALL blanks in English.itute
School name, School District, or State Dept. of Education	U.S. State where located

Initial date to initiate teacher exchange program	End date of J-1 visa term

LAST NAME of school contact	FIRST NAME(S) of school contact	MIDDLE NAME(S) of school contact

Type of school	DDate school was established	Title of School Contact
Public Private
Address of school /district:

City	State	Zip Code

Number of teachers	Country of Origin	Additional Country of Origin

Email address of school contact	Telephone no. of school contact

School website address	School fax number

Level that teachers will teach Primary Secondary	Both? Yes No
Teacher name(s)

Email address of the person completing this form
Subject(s) to be taught
If a teacher is already in the U.S., what is the current visa status?
Has any candidate already (1) applied for or (2) lived in the U.S. in H1-B visa status? Yes No
Private Schools: Please FAX to 646-349-3455 A COPY OF State School Certification

To submit this form, click the submit button below.

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