Organization *

First Name *

Last Name *

Title *

Phone *

Email *

Will you be the direct supervisor of the intern or trainee? *

Yes

No

If not you, please provide us with name, title and contact details of direct supervisor.

Primary address where intern or trainee will be completing their J-1 program: *

How many full-time employees that are U.S. citizens or permanent residents will be on site? *

Has your company or organization already signed up for BelCham Business Membership?* *

Yes

No

Please upload draft DS-7002 Training Plan *

20MB max

Please upload Company's Workers Compensation Certificate *

20MB max

I confirm that I have read and meet all requirements as a J1 visa host company. *

-The training program (for the Intern/Trainee) is in line with the visa applicant’s education & work experience 

-The Host Company employs at least 2 full time US Citizen/Permanent Resident staff 

-The Host Company has the means to be able to appropriately supervise, train, and support the Intern/Trainee throughout their program

-All training will take place in person in a dedicated office setting (remote work 100% is not allowed)

-Training will be full time (minimum 32 hours per week)

-Training will not include more than 20% clerical or administrative work

-Training will not displace or replace an ordinary staff member (full time or part time), nor may they fill a labor need of the company

Yes

No

Host Company Agreement *

1. I agree to act in accordance with all United States Department of State ("DOS") regulations relating to Exchange Visitor Programs. 
2. I affirm that the Host Company Application and DS 7002 training plan accurately reflects the content of the training/internship and experience being extended to the trainee/intern. 
3. I agree to provide all trainees/interns with a comprehensive orientation program which will include giving them a packet containing office rules, a training/internship program plan, emergency information, and other information as required by DOS regulations. In addition, I will suggest to all trainees/interns specific neighborhoods and places of interest to visit and cultural events to attend. 
4. I will be responsible for ensuring that my employees possess and maintain the demonstrable competence to provide training/internship in the subjects offered to each exchange visitor, and I hereby affirm that the training/internship plan truly reflects the content of the training experience being extended to the trainee. 
5. I certify that there are sufficient plant, equipment and trained personnel to provide the training/internship specified in the training plan, that the training/internship is not designed to recruit and train aliens for employment in the U.S., and that the trainees/interns will not replace full-time U.S. employees. 
6. I affirm that the Host Company abides by all federal, state, and local occupational health and safety laws. 
7. The Host Company will provide cross/cultural activities or events for trainees/interns throughout the duration of their program. 
8.  I understand that all trainees/interns must be covered by health and accident insurance, as specified in the Federal Regulations, during their entire length of stay. If the trainee/intern and I choose to meet this requirement through a training/internship entity insurance plan, I understand that is my responsibility to maintain this coverage continuously during the trainee/intern’s presence in the United States on the J-1 Visa. 
9.  I will neither encourage nor render any assistance, including helping a trainee/intern change visa categories, which would keep a trainee/intern in the United States beyond the end date shown on the DS-2019, the document governing the trainee/intern’s admission and stay in the United States. I also understand that, for trainees, eighteen (18) months is the maximum time allowed for training while for intern the maximum time for training is twelve (12) months. 
10.  I agree to submit all changes affecting the trainee/intern to BelCham in advance for approval. Such changes include, but are not limited to, location, content, and length of training/internship. I agree to communicate immediately by phone and written correspondence any circumstances which differ from the Company Application and DS 7002 training plan. I will submit all requests regarding a transfer of the trainee/intern to another training/internship location during the program three (3) to four (4) weeks prior to the date of transfer. 
11.  I understand that the BelCham may inspect my training/internship facilities, equipment, and physical plant and conduct interviews with the trainees/interns and the supervisors. I also understand that if BelCham finds that I have failed to fulfill any obligation, it will recommend program changes to the supervisor in order to rectify the problem. I agree that BelCham may disqualify me from participation in the program if I materially or consistently fail to achieve BelCham’s training/internship objectives. 
12. I agree to complete mid-program and end-program supervisor evaluations in a timely manner. 
13. I agree to respond to any requests by BelCham concerning my company’s trainees/interns in a timely manner and complete and follow through on any paperwork required by BelCham. 
14. I will immediately report to BelCham any concerns regarding the health, safety or welfare of the Intern/Trainee. 
15. I understand that BelCham has the right to withdraw sponsorship from any trainee/intern, whose training/internship entity does not comply with BelCham’s program, compelling that trainee/intern to leave the country, and to deny all future applications from that training/internship entity. There will be no refund of the program fee if sponsorship is withdrawn. 
16. If a trainee/intern ceases his or her training/internship program for any reason, I will inform BelCham within three (3) days. 

Enter required value Yes