© UC Santa Cruz
Maintained by mtbrown@ucsc.edu

Apprenticeship Visa Information Sheet

Name ________________________________________ (last, first, middle)

Male ____ Female _____ (please check one)

Date of Birth ______________ (month/day/year)

Country of Citizenship_____________________________ (city, country)

Country of Birth _________________________________ (city, country)

Country of legal permanent residence _________________________________

Date of entry to U.S. ______________________________

Consulate where scholar will apply for visa, if out of U.S. ___________________

POSITION IN COUNTRY OF PERMANENT RESIDENCE: If position is in education, state level (i.e., postdoc, grad, undergrad, secondary; also if self-employed, private or government employer)

____________________________________________________

____________________________________________________

Current address _________________________________________________

_____________________________________________________________

Permanent address _______________________________________________

_____________________________________________________________

SOURCE AND ESTIMATED AMOUNT IN U.S . DOLLARS: for entire six-month period of the apprenticeship:

U.S. government agency (specify)_____________________ Amount $__________

 

Scholar's government agency (specify)_________________ Amount $__________

 

Other (describe)________________________________ Amount $__________

 

Personal funds__________________________________ Amount $__________

DOES THE SCHOLAR CURRENTLY HOLD A NONIMMIGRANT VISA? ____ yes ____ no

If yes, what type? __________________