J-1 Scholar Out of Country Notification Form

This form is to be completed by a J-1 scholar with an RIT-issued Form DS-2019 who needs to depart the US during their J-1 program to conduct work related to their J-1 program. This form must be submitted in advance of departure from the US. Information provided on this form will be used to update the scholar’s SEVIS record. This form is not to be used by J-1 students. For time outside the US for personal or other activities not related to your J-1 program, do not use this form but instead email Megan Kless. Questions? Contact Megan Kless: mkiss@rit.edu

By submitting this form, you attest to the following:

I understand that any changes to my Out of Country activities (nature of work, dates, location) require that I submit an updated form.
I understand it is my responsibility to clear my absence from RIT with my RIT supervisor.

J-1 Scholar First/Given Name(s)

J-1 Scholar Last/Family name(s)

J-1 Scholar Email

J-1 Scholar SEVIS ID

Out of Country Begin Date

Out of Country End Date

Out of Country Location Name

Name of institution or organization where you will be working outside of the U.S.

Out of Country Location Address

Address Line 1

Address Line 2

City

Country

Province/Territory

Postal Code

Please describe the work you will be doing outside of the U.S. and how it relates to your J-1 program:

Please allow 2 - 3 business days for processing. You will receive an email when your SEVIS record has been updated.

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