J-1 SWT Application Form

PERSONAL INFORMATION
Family Name*
Last
(as spelled in passport)
First and Middle Name*
First Middle
(as spelled in passport - omit middle name if not in passport)
Please Select Male or Female*
- Male
- Female
Date of Birth*
MM slash DD slash YYYY

American Date Format: mm/dd/yyyy
Place of Birth (City)*
Place of Birth (Country)*
Country of Citizenship*
Country of Legal Permanent Residence*
Student's Current Mailing Address*
City*
Country*
Eircode*
Contact Number*
Email*
Enter Email Confirm Email
Emergency Contact Name*
Emergency Contact Relationship*
Emergency Contact Number*
Emergency Contact Email*
J-1 Summer Work Travel Previous Experience
Have you ever been on a J-1 work / travel program?*
- Yes
- No
If Yes, how many times?*
Maximum number of times for participation on this program is three.
Where in US do wish to do your J-1 Summer Work Travel Program?
Preferred Destination State(s) For Summer Work Travel Program*
You can enter more than one or 'Any'
Do you have summer accommodation organised in the US?
If you know where you will be staying in the US during your J-1 summer program please describe.
Housing Organised?*
- Yes
- No
Housing description*
J1 US EMPLOYMENT DATES
Republic of Ireland college students (including those on Erasmus) allowed to work between the 15th May - 15th September. U.K./Northern Ireland, college students allowed to work from the 1st June - 15th September. You are only allowed to travel from the 15th May and up to 30 days after your J1 work end date. All job offers are based on the dates that you provide below (ONLY SPECIFY WORKING DATES AND NOT TRAVEL DATES).
What is your intended J1 work start date?*
MM slash DD slash YYYY

If you are not sure put in your best estimate.
What is your intended J1 work end date?*
MM slash DD slash YYYY

If you are not sure put in your best estimate.
University Information
Name of University/Institution of Higher learning*
Address of your University/Institution of Higher Learning*
Start Date of University Summer Vacation*
MM slash DD slash YYYY

American Date Format mm/dd/yyyy. N.B. Please ensure this date is accurate.
End Date of University Summer Vacation*
MM slash DD slash YYYY

American Date Format mm/dd/yyyy. N.B. Please ensure this date is accurate.
Major Field of Study*
Type of Degree*
- Undergraduate
- Graduate
How many years of University Level Studies will you have completed?*
Enter number of years
When do you expect to receive your diplomacy/degree?*
Enter Month/Year
Required Supporting Documents
Drop files here or

Max. file size: 256 MB.
Email
This field is for validation purposes and should be left unchanged.

PERSONAL INFORMATION

J-1 Summer Work Travel Previous Experience

Where in US do wish to do your J-1 Summer Work Travel Program?

Do you have summer accommodation organised in the US?

J1 US EMPLOYMENT DATES

University Information

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