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Princeton University – Davis International Center  Application for Certificate of Eligiblity (DS-2019)

International Student Intern Program

Please complete this application in order to be issued a Certificate of Eligibility for Exchange Visitor Status (DS-2019), which is required for you to apply for the J-1 student intern visa stamp at a U.S. Embassy or Consulate abroad. All sections of this form must be complete and accompanied by the necessary documents to verify your eligibility and ability to cover the minimum expenses in order to participate in the International Student Intern Program at Princeton University. Lack of documentation or incomplete information will delay the issuance of your DS-2019. All information that you provide will be kept confidential.

INSTRUCTIONS: Please upload the completed form and required documents (numbers 1 & 2 below) to the DocuPort:https://intlctr-check-in.princeton.edu/docuport/intlctr_humancheck.php

1) All required financial documentation demonstrating funding noted in chart below2) A copy of your passport biographical page

3) Enter Exact Start Date (if known) ______________ and Exact End Date (if known) _______________Sign-up and Pay for eShip Global to have your U.S. immigration documents mailed (REQUIRED)

SECTION I: PERSONAL INFORMATION Please complete the sections below. Your name must be consistent on all immigration documents to avoid problems at the U.S. Embassy/Consulate and/or upon your arrival in the U.S.

Please check one: Male Female _______________________ Date of Birth (mm/dd/yyyy)

Passport Name: _____________________________________________ ____________________________________________

Last/Family Name(s) First/Given Name(s)

________________________________ __________________________ __________________________ City & Country of Birth Country of Citizenship Country of Legal Permanent Residence

________________________________________________________________Email

SECTION II: ADDRESS INFORMATION Please provide a permanent (residential) address in your country of citizenship or country of permanent residency. This address must be a permanent residential address outside the U.S. in order to receive the shipment of your DS-2019.

_____________________________________________________________________________________ ___________ House Number and Street Apt # (if any)

____________________________ ____________________________ __________________________ ___________ City State / Province Country Postal Code

Enter Source of Funding (where applicable)

Princeton University Personal Funding Name of Family Provider Name of Third Party

Provide Required Documentation

(where applicable)

If any funding provided by Princeton University

Copy of Official Bank Statement/Record with

Applicant’s Name Indicated on Documents

Copy of Official Bank Statement/record with

Family Member/Relative’s Name

Copy of Official Letter from Home Institution, Government or

Sponsoring Agency

Amount of Funds $ $ $

SECTION IV: STUDENT STATEMENT By submitting this form, I hereby certify that the information is complete and accurate to the best of my knowledge and will sign-up and pay for eShip Global to receive immigration documents.

$

4)__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

___________________________________________________________________________________________________________SECTION III: STUDENT FINANCIAL Cost of ISIP Program $4,000 for 8 week program. Any additional week(s) require an additional $500 per week. Source(s) of funding should cover duration of program.

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