Academic Training Request Acknowledgement Letter
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Education Educación training formación student estudiante Program Programa Academic Académico
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August 13 J-1 Student Academic Training Form PART I (to be completed by student) Name (last, first): Local (U.S.) address: Phone number: Student ID: Major(s): Personal Email: Program Completion Date: Level of Education: MM / DD / YYYY Have you ever participated in Academic Training (AT) yes no Dates of previous AT (if applicable): MM / DD / YYYY to MM / DD / YYYY Proposed Employment Employer’s Name: Supervisor’s First and Last Name: Employer’s Address: Employer’s Phone Number: Dates of Employment (Start and End dates): Part-time (20 max.) Full-time (20+) MM / DD / YYYY to MM / DD / YYYY I’m requesting the above work authorization because I have received an employment offer for the specified employer and employment dates, and I understand that the employment authorization is for this employment and these dates only..
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