Train USA - Host Company Application

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1 Please complete all fields of the following application with as much detail as possible. Cultural Vistas will evaluate the completed Participant Application and Host Company Application according to an application window that corresponds with the training program start date. So long as both completed applications are submitted within the given window, and the program is approved for sponsorship, applicants will receive Form DS-2019 at least one month in advance of their training start date. Incomplete applications and applications received after the window has closed will be evaluated within the next window, or applicants may opt for our 5-day expedited processing option for an additional fee. For more about our application windows see: Standard application review requested Expedited application review requested (additional fee) Please indicate the party responsible for payment of the following fees associated with the processing of this application: Host Company Participant Other Administrative Fee SEVIS Fee Health Insurance Fee Pre & Post Program Health Insurance Fees (if applicable) J-2 Dependent (if applicable) Expedited Processing Fee (if applicable) If the Host Company, or Other, is responsible for fees listed above, please provide the following for invoicing purposes. Bill to: Name: Company Affiliation: Title: Participant Information First Name Last Name Address Host Company Company Name Parent Company Website Year Founded Number of Full-time U.S. Employees If fewer than 25: Number of Part-time Number of Contractors EIN Annual Revenue (USD) 0-3 million 3-10m 10-25m 25+m Do you have a valid workers compensation insurance policy? Yes No Policy No. Start Date End Date Carrier Will your workers compensation policy cover the participant? Yes No If exempt, documentation of State Law Exemption must be provided. Page 1

2 Training/Internship Supervisor Salutation First Name Last Name Department Title Work Phone Fax Mobile Work Address 1 Work Address 2 City State Postal Code Host Company Representative Salutation First Name Last Name Department Title Work Phone Fax Mobile Work Address 1 Work Address 2 City State Postal Code Attorney Is an attorney representing the Host Company in this application? Yes No Attorney Name Firm Name Phone Fax Address 1 Address 2 City State Postal Code Page 2

3 Training/Internship Location Address 1 Address 2 City State Postal Code No. of FT Employees at Program Site No. of J-1 Participants on site during this program No. of Employees in Participant s Department Nearest Airport Training/Internship Position Details Title Start Date End Date Host Company conducted an interview with the participant and documented it? Yes No Interview was conducted by Name Date Method of interview In person Videoconference Telephone Summary of interview conducted evaluating the participant s ability to undergo training in the United States. Motivation for participating in the J-1 Exchange Visitor Program and supporting cross-cultural exchanges. How was the participant recruited? Referred to Cultural Vistas by Host Company Attorney Partner Other: Page 3

4 Compensation and Benefits Party Responsible Est. Hours/week (Min. 32) Compensation Amount per Compensation Type Wage Stipend Other: Payment Schedule Other Compensation Est. Overtime Hrs/Wk Hourly Overtime Wage Payroll Deductions for housing, visa fees, etc. Explanation Company Contribution to Participant s Travel Expenses Portion of Expenses Provided Description of benefits provided by the company at no cost to the participant and monthly value of each. Do you advise purchasing an automobile? Yes No Transportation available company provided walk public other Cost of Living These estimated expenses will be provided to the participant so that they can financially prepare for living in the area surrounding their internship location. Est. monthly cost of Rent Transportation Food Housing Assistance Provided No Yes If yes, please provide a description below. Page 4

5 Training/Internship Placement Plan Instructions The DS-7002 Training/Internship Placement Plan is a Department of State document which serves as a contract for the program outlining the details of the position and informing both parties of the expectations for the program. Please complete the sections below for review by a Cultural Vistas staff member. If J-1 visa sponsorship is extended, Cultural Vistas will send you a copy of this form to sign during the final stage of the application process. Plan requirements: The plan should be as specific as possible and be individualized for your participant. In some cases, the plan must include multiple phases. Each phase must build upon the previous phase to show a progression in the training/internship. This page must be completed for each phase. Training plans for Interns may consist of one phase. Interns are participants who are currently in school or graduated no more than 12 months prior to the start date. Training plans for Trainees must consist of multiple phases. Trainees are participants who possess a degree plus one year work experience or 5 years work experience. Tips: The training plan will be used by a Consular official to determine whether to grant the J-1 visa to your participant. Thus, the plan should be written in layman s terms, and all acronyms must be spelled out. Six months per phase is recommended. All hospitality and restaurant plans must have a minimum of three phases. If you have hosted this participant on a previous program please make sure the new training plan represents an advanced training and is not duplicative of the prior program. Page 5

6 Training/Internship Placement Plan Phase of Name of Phase Start Date End Date Describe the role of the intern or trainee within the host company for this phase. Describe the goals and objectives for the participant during this phase. What is expected the participant will achieve upon completion? New knowledge, skills, or techniques the participant will acquire during this phase. Detailed list of activities and tasks the participant will partake in during this phase. Include daily responsibilities, how they will be trained (job shadowing, classroom style, lecture, tutorials, etc.) and by whom, and a time line outlining which business areas they will be exposed to. Who provides continuous on-site supervision and mentoring? Why was this person chosen? Describe their qualifications including years of experience in the field and with the host company for supervising the intern during this phase. How will the participant s acquisition of skills be evaluated during this phase? How often? How will you expose the intern or trainee to American culture? Please include activities such as office events, cultural outings, community engagement, holiday celebrations, and any other activities you will inform them of, or invite them to. Page 6

7 Training/Internship Placement Plan Phase of Name of Phase Start Date End Date Describe the role of the intern or trainee within the host company for this phase. Describe the goals and objectives for the participant during this phase. What is expected the participant will achieve upon completion? New knowledge, skills, or techniques the participant will acquire during this phase. Detailed list of activities and tasks the participant will partake in during this phase. Include daily responsibilities, how they will be trained (job shadowing, classroom style, lecture, tutorials, etc.) and by whom, and a time line outlining which business areas they will be exposed to. Who provides continuous on-site supervision and mentoring? Why was this person chosen? Describe their qualifications including years of experience in the field and with the host company for supervising the intern during this phase. How will the participant s acquisition of skills be evaluated during this phase? How often? How will you expose the intern or trainee to American culture? Please include activities such as office events, cultural outings, community engagement, holiday celebrations, and any other activities you will inform them of, or invite them to. Page 7

8 Training/Internship Placement Plan Phase of Name of Phase Start Date End Date Describe the role of the intern or trainee within the host company for this phase. Describe the goals and objectives for the participant during this phase. What is expected the participant will achieve upon completion? New knowledge, skills, or techniques the participant will acquire during this phase. Detailed list of activities and tasks the participant will partake in during this phase. Include daily responsibilities, how they will be trained (job shadowing, classroom style, lecture, tutorials, etc.) and by whom, and a time line outlining which business areas they will be exposed to. Who provides continuous on-site supervision and mentoring? Why was this person chosen? Describe their qualifications including years of experience in the field and with the host company for supervising the intern during this phase. How will the participant s acquisition of skills be evaluated during this phase? How often? How will you expose the intern or trainee to American culture? Please include activities such as office events, cultural outings, community engagement, holiday celebrations, and any other activities you will inform them of, or invite them to. Page 8

9 Host Company Obligations and Responsibilities As the Host Company Representative: I affirm that this application and Training/Internship Placement Plan truly reflect the content of the internship or training offer made to the exchange visitor participant. I understand that Cultural Vistas, not the company I represent, is the legal sponsor of the program and of this exchange visitor. I certify that sufficient physical plant, equipment and trained personnel will be dedicated to providing the specified program. I certify the program is not designed to recruit and train aliens for employment in the United States. I certify the exchange visitor will not displace full-time, part-time, temporary or permanent American workers or serve to fill a labor need. The position my company offers exists solely to assist the participant in achieving the objectives in the training plan. I understand the host company I represent is responsible for abiding by all applicable federal, state, and local labor and wage laws including requirements for Workers Compensation Insurance. Failure to do so may result in cancellation of this program by Cultural Vistas. I agree to notify Cultural Vistas of any change in the information provided herein including location, content, length, wages, or supervisor. Changes must be submitted for approval in advance. Any case of dismissal or resignation by a participant must be reported immediately and will result in cancellation of the program requiring exit from the United States within 10 days. The organization I represent will not encourage or assist the exchange visitor participant to stay in the United States beyond the period permitted by the DS-2019 nor will we assist the participant with changing his or her visa status while under Cultural Vistas sponsorship. I agree to respond to any requests by Cultural Vistas concerning my organization s participants in a timely manner and to complete any paperwork, including mid-term and final evaluations. Further, I agree to ensure my participants submit all required information and forms to Cultural Vistas including notice of arrival and address updates. I understand that Cultural Vistas has the right to withdraw sponsorship from any exchange visitor participant whose host company does not comply with any and all program rules and regulations or any participant who violates program rules and regulations. I understand the U.S. consulate or embassy will make the final determination whether to issue the J-1 Exchange Visitor visa. Cultural Vistas has no power to influence either a positive or negative decision on a participant s behalf. The participant takes part in the program at his or her own risk and of his or her own volition. Cultural Vistas and its partner organizations cannot be held liable under U.S. law, the law of the participant s home country, or the law of the country or countries in which the program takes place for any damage or injury, such as injury to persons or damage to property, suffered or caused by the participant in the course of the program. I understand that Cultural Vistas and partners undertake a variety of activities to adequately prepare participants for their program abroad, including, but not limited to: information on health and safety issues in the host country, insurance issues, housing and accommodation, visa and residency requirements, political and cultural conditions, roles and responsibilities of partners and host companies, and select laws specific to the United States. Beyond this preparatory information, a range of issues related to a participant s experience can occur and are beyond the control of Cultural Vistas and partners. Cultural Vistas and its partner organizations cannot: Guarantee the safety of participants or eliminate all risks from the participant s environment while in the United States; Prevent participants from engaging in illegal, dangerous or unwise activities; Assure that home-country standards of due process apply in overseas legal proceedings or provide or pay for legal representation for a participant; Assume responsibility for the actions of persons not employed or otherwise engaged by Cultural Vistas, for events that are not part of the program, or that are beyond the control of Cultural Vistas and its subcontractors, or for situations that may arise due to the failure of a participant to disclose pertinent information. Bear liability for any financial obligation that the participant may incur due to lack of adequate insurance coverage outside of any program-provided insurance; Assure that home-country cultural values, norms, and laws will apply in the United States. The Parties [person or entity named in this application] agree that arbitration is the required and exclusive forum for the resolution of any and all disputes between them. Read the entire arbitration agreement on our Web site at or request a copy be sent to you by contacting us at I hereby attest that I have read and understood the Conditions of Participation and Liability Information listed above, and I accept them as binding for the duration of the program. I acknowledge and accept the limitations to the liability of the administering organization as listed above. I hereby release Cultural Vistas, Inc., its officers, directors, agents, partners, representatives, successors, and assignees from any claims and causes of action, heretofore or hereafter arising, known or unknown, by reason of violence or natural disasters affecting me or my property while participating in this program. I agree that arbitration is the required and exclusive forum for the resolution of any and all disputes between me and Cultural Vistas, Inc., in accordance with the arbitration agreement posted online at I attest that I have read and understand the information given above and certify that all statements made by me in this application are true and correct. First Name Last Name Signature Date Page 9

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