J-1 Exchange Visitor Info Form

This form is used to collect the information necessary to support J-1 Exchange Visitors as they join the Amherst community.  This form should only be filled out by:

  • individuals hired as Language Assistants by the French, Spanish, German, and Russian Departments, or
  • students attending Amherst College as part of an exchange program

Your DS-2019 cannot be issued until all mandatory fields in this form are completed and you have submitted the form. Be certain that the information provided here is identical to the information contained in the passport that you will be using to travel to the United States.

Please select the category that applies to you.
Personal Information
First/Middle/Last
Date of Birth: *
(Identify all countries through which you hold citizenship; if you hold multiple citizenships, separate the countries by commas. For example: United Kingdom, Republic of Ghana)
(If you are a citizen of more than one country, specify which country's passport you will use for travel to the United States as a student)
Permanent Residential Home Country Address
Please enter your address in the manner typically used in your home country. 
Documents Mailing Address
Unless we are informed otherwise, your visa documents will be sent to the "Permanent Residential Home Country Address" you've provided above. If there is another, different mailing address to which you want your documents sent, please enter it below in the exact manner to be used for addressing mail to you.
Latest Date for Your Receipt of Mail Sent to this Address:
Information of Parents, or Close Relative--Preferred Contact
Information of Parents, or Close Relative--Secondary Contact
Please upload a photo/copy of your passport biographical page. (The "bio page" in your passport is the primary page of your passport. It typically provides key information such as your full name, date of birth, and citizenship information.)
Validation
CAPTCHA Image

Enter the characters shown in the image or use the speaker icon to get an audio version.