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  • J-1 Summer USA
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J-1 Intern Program Application Form 2023

Step 1 of 7

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  • Please Have Required Documents Ready for Upload in Order to Complete Form

    Your  program start date must be within 12 months of your final class at your University. 

    1. Signed & Stamped Copy Of Proof Of College (Download link) PDF or Scan Of Graduation Certificate or College Proof of Attendance. Just one of these has to be uploaded.
    2. Signed Copy Of Rules & Regulation Form PDF (Download link)
    3. T/IPP Questionnaire (Download link)    Notes on Training Plan must be adhered to.
    4. Business or organisation's Worker's Compensation Document
    5. CV or Resume PDF
    6. Passport JPEG. Good quality scan - not a photo.
    7. Proof of funds PDF
    8. Copy of previous US visas if applicable PDF.
    9. Copy of Irish visa (third party nationals) if applicable PDF.
  • J-1 INTERN PROGRAM FOR IRELAND 2017 PROGRAM APPLICATION

    PERSONAL INFORMATION

    Important! This information must appear exactly as it does on your passport.

  • Date Format: MM slash DD slash YYYY
    American Date Format: mm/dd/yyyy
  • PERMANENT ADDRESS

  • EMERGENCY CONTACT

  • COLLEGE ATTENDANCE DETAILS

  • COLLEGE ATTENDANCE DETAILS

  • (Eg. Bachelor of Business Studies BSc Business, Masters of Elkectrical Engineering MSc Engineering)
  • Date Format: MM slash DD slash YYYY
    American Date Format: mm/dd/yyyy
  • Personal Reference

  • Professional Reference

  • VISA AND TRAVEL INFORMATION

  • If yes, please fill out the following for each visa:
  • Please enter a number from 1 to 2.
  • Date Format: MM slash DD slash YYYY
    American Date Format: mm/dd/yyyy
  • Date Format: MM slash DD slash YYYY
    American Date Format: mm/dd/yyyy
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • If yes, please fill out the following for each visa:
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Select Yes or No
  • Select Yes or No
  • Select Yes or No
  • Select Yes or No
  • INTENDED START/COMPLETION DATES

  • Date Format: MM slash DD slash YYYY
    American Date Format: mm/dd/yyyy.
  • Date Format: MM slash DD slash YYYY
    Note: you can enter up to 30days prior to the date above. American Date Format: mm/dd/yyyy.
  • Date Format: MM slash DD slash YYYY
    Note: your program allows a 12 month opportunity and you can depart up to 30 days after the date above. American Date Format: mm/dd/yyyy.
  • EXPECTATIONS

  • INTERNSHIP INTERESTS

  • HISTORIC, SOCIETAL, CULTURAL INFORMATION

    The United States Department of State believes that a participant coming to the United States on a J1 Program – should not only gain a valid internship to help with their future career – but should also gain a better understanding of America and it’s History, Society & Culture. We agree!! Tell us a little bit about what might interest you while you are here and we will develop a program of learning for you. (check all that apply).
  • HISTORIC, SOCIETAL, CULTURAL INTERESTS INFORMATION

    check all that apply
    *
  • APPLICATION CHECKLIST

    1. SIGNED & STAMPED COPY OF PROOF OF COLLEGE PDF
    2. SIGNED COPY OF RULES & REGULATION FORM PDF
    3. CV or RESUME PDF
    4. REFERENCES PDF 
    5. PASSPORT JPEG
    6. PROOF OF FUNDS PDF
    7. COPY OF PREVIOUS US VISAS IF APPLICABLE PDF
    8. COPY OF IRISH VISA (THIRD PART NATIONALS) IF APPLICABLE PDF
  • Drop files here or
    Accepted file types: pdf, docx, jpeg.
    Upload Required PDF Documents. Allow time for documents to upload (Max file sizes: 2MB).
  • Drop files here or
    Accepted file types: jpg.
    Upload Required JPG. Allow time for documents to upload (Max file size: 2MB).
  • This field is for validation purposes and should be left unchanged.
J1 Ireland is an agent for the J-1 program.
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Contact Info

Roscommon, F42 XH51
Academy House, Goff Street,

Phone: +353 (0)90 6494997

Email: info@j1ireland.com

Mon-Fri: 9:30AM – 5:00PM

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