CAREER TRAINING USA Intern/Trainee Application for J-1 ...1].pdf · CT–PA01–1212 Page 1 of 17 CAREER TRAINING USA Intern/Trainee Application for J-1 Visa Sponsorship PROGRAM DESCRIPTION

CT–PA01–1212 Page 1 of 17

CAREER TRAINING USAIntern/Trainee Application for J-1 Visa Sponsorship

PROGRAM DESCRIPTIONInterExchange Career Training USA is designated to sponsor two J-1 Visa categories: Intern and Trainee. You must determine which program is appropriate before you complete the application. Please also visit www.InterExchange.org/ct-participant-requirements to view any updates to these requirements.

Intern Trainee

Eligibility Currently enrolled in a degree- or professional certificate-granting post-secondary (above high school) academic institution outside the USA

OR

Have graduated from such an institution no more than 12 months before program start date

A degree or professional certificate from a foreign post-secondary academic institution and at least one year* of related professional experience acquired outside the USA

OR

Five years* of related professional experience acquired outside the USA

Duration Up to 12 months Up to 18 months**

Program Focus Internship must be related to academic field of study Training program must be related to occupational field

Repeat Participation Yes, if still a student or recent graduate (current students must return to school for at least one term before reapplying for the Intern visa)

Yes, but must wait at least 2 years after the end of a previous J-1 Intern or Trainee program. (This applies to all participants and is not related to Rule 212(e).)

* If your program eligibility is based on years of experience, your letters of reference must be from former employers who can fully document your length of employment. More

than 2 letters of reference or additional verification of employment may be required to determine your eligibility. Please also note that U.S. work experience cannot be considered for program eligibility, per federal regulations.

** Hospitality & Tourism training programs cannot exceed 12 months.

ADDITIONAL PROGRAM REQUIREMENTS Your host employer must be eligible to host interns/trainees. See www.InterExchange.org/ct-employer-requirements for more details.

You must be between the ages of 18 and 38.

Your internship or training program must be related to your studies (Interns) and/or professional experience (Trainees).

You must be interviewed in-person, over the phone or via web camera by InterExchange or an approved InterExchange partner.

You must have verifiable English language skills and possess comprehension of English terminology of your field.

You must be covered by sufficient Accident & Sickness insurance for the length of your stay in the United States prior to your arrival in the USA, in accordance with US State Department regulations. Insurance is included in your program fee, and you may not decline this coverage.

You must have sufficient funds to support yourself during your entire stay in the USA (including housing and living costs).

Your internship must be in a field that InterExchange is designated to sponsor, including the following: Architecture, Business, Commerce & Finance, Engineering, Hospitality & Tourism, Information Media & Communications, Management, Marketing & Sales, Public Administration & Law, the Sciences, and Industrial Occupations. InterExchange cannot sponsor training programs in the arts (Arts Administration is allowed), medicine, teaching, social work, or manual labor.

You must be applying for the J-1 visa from outside the USA. If you require a change of status to obtain the J-1 visa, you will not be eligible to apply through InterExchange. If you recently completed a degree and/or OPT within the USA, you may not apply for J-1 visa sponsorship through InterExchange. Similarly, if you recently spent significant time in the U.S., you may not be eligible to apply at this time. Contact InterExchange to discuss your specific circumstances before applying.

If you are already in the USA on an InterExchange Career Training USA program, you may be eligible to extend your program. Please contact us for the appropriate application.

www.InterExchange.org/ct-participant-requirements

www.InterExchange.org/ct-empolyer-requirements


CAREER TRAINING USA Intern/Trainee Application

Application ChecklistApplicant Name:

International cooperator/university/law firm assisting with application (if applicable):

Complete and attach this form to your completed application. Please do not submit your application until you have gathered all the required materials—we cannot review applications that are incomplete.

APPLICATION FORM REQUIRED SUPPLEMENTAL DOCUMENTS

2 passport-sized, color photos

Full program fees

Payment Method: (check the appropriate option)

Completed Fee Payment Form enclosed

Online Payment Confirmation #:

Check/Money Order (attached)

Application form (must be typed)

Applicant Information

Internship/Training Objectives

Résumé (Please attach a separate document with any details that do not fit on this form)

Cost of Living Worksheet (Research your host city and provide an estimate)

Participant Agreement Form (must indicate email address and be hand signed and dated)

EMPLOYER DOCUMENTS

You must collect and submit all required employer documents with your application—see the employer application for full details and checklist

All documents must be in English or translated into English by an OFFICIAL English translator. All translations must be accompanied by the original documents.

Copy of official transcript, degree/certificate, or signed statement from a post-secondary academic institution outside the USA indicating that you are either currently enrolled or have graduated

2 letters of reference (Trainees’ letters must also confirm length of employment.) Ensure that your letters:

Have been written and dated in the last 12 months by a previous or current non-U.S. employer or professor

Are signed by the reference

Are completed on letterhead or have reference’s business card attached

Indicate reference’s relationship to you

Include exact dates of employment (for Trainees)

Additional letters for verifying previous employment, if applicable (see Program Description on Page 1 for more details)

Interview Form completed by international cooperator (independent applicants will be interviewed via phone by InterExchange after your application is reviewed)

Copy of passport photo page (passport must be valid at least 6 months past program end date)

Copy of all previous U.S. visas

Copy of your bank statement or a signed statement from a parent/guardian to prove that you will have sufficient funds for the entire length of your program.

Copy of DS-7002 Form for any previous J-1 Intern/Trainee Visas

FOR DEPENDENTS

Copy of passport photo page for each dependent (passport must be valid at least 6 months past program end date)

Copy of all previous U.S. visas for each dependent

Signed dependent agreement for each dependent over age 18-- applicant must sign a dependent agreement for any dependents under 18

Full program and insurance fees for each dependent

PROCESSING TIME

Our review time is approximately two weeks once we receive a complete application and full payment. We will not review your application until all documents and payment have been submitted. If your employer requires a site visit the review process may take longer. See the Employer Application for more information about site visits.

We do not expedite the review under any circumstances--please apply at least 2 months before your start date to allow sufficient time for the InterExchange application review and Embassy/Consulate appointment, as well as to finalize your travel arrangements.

SUBMISSION INSTRUCTIONS NOTES

Option 1: Email to [email protected]

Option 2: Mail to: InterExchange, Inc Career Training USA 161 Sixth Avenue, 10th Floor New York, NY 10013 United States

Please make copies of all documents before submitting to InterExchange. Original documents will not be returned once submitted for review.

We do not make any promise or guarantee that visa sponsorship will be granted or that you will receive a visa from the Embassy/Consulate. It is highly recommended that you do not purchase non-refundable airfare prior to visa issuance.

mailto:[email protected]



Print name exactly as it appears on your passport. Application must be typed. (See cover page for program details)

Program you are applying for:

Intern

Trainee

APPLICANT INFORMATION

FAMILY NAME FIRST NAME MIDDLE NAME

Male FemaleDATE OF BIRTH (MM/DD/YYYY) SEX CITY OF BIRTH

COUNTRY OF BIRTH COUNTRY OF LEGAL PERMANENT RESIDENCY COUNTRY OF CITIZENSHIP (COUNTRY ISSUING PASSPORT)

EMAIL ADDRESS (REQUIRED—THIS IS HOW WE COMMUNICATE WITH APPLICANTS) SKYPE ID (IF APPLICABLE)

— —COUNTRY CODE – CITY CODE – PHONE NUMBER

YOUR PRESENT SHIPPING ADDRESS (WHERE UPS CAN DELIVER)

CITY COUNTRY POSTAL CODE

EMPLOYER INFORMATION

HOST EMPLOYER/COMPANY NAME SUPERVISOR NAME (LAST, FIRST)

EMPLOYER ADDRESS (ACTUAL LOCATION OF INTERNSHIP/TRAINING PROGRAM CITY STATE ZIP CODE

SUPERVISOR PHONE SUPERVISOR EMAIL ADDRESS

PROGRAM LENGTH

Expected Start Date: (The date you will start working at your host company)

Program Duration in Months: 1-12 Months (Interns & Hospitality Trainees); 1-18 Months (Trainees - non-Hospitality)MM/DD/YYYY FULL MONTHS ONLY

DEPENDENT INFORMATION

If you are married and/or you have children and plan to bring them with you to the USA, complete the information below. If you have more than 1 dependent, provide the information on separate paper and attach a copy of each dependent’s passport. All dependents must also be covered by Accident and Sickness Insurance for the entire duration of the program. Please provide full program and insurance fees for all dependents.

Are you bringing dependent(s) with you to the USA? Yes No How many?

FAMILY NAME

Spouse Child

FIRST NAME

Male Female

MIDDLE NAME

RELATIONSHIP OF DEPENDENT TO TRAINEE SEX DATE OF BIRTH: (MM/DD/YYYY) CITY OF BIRTH

COUNTRY OF BIRTH COUNTRY OF LEGAL PERMANENT RESIDENCY COUNTRY OF CITIZENSHIP (COUNTRY ISSUING PASSPORT)

Attach photo here.

smile

Photos should be no larger than the space

provided here.

Dependents must also sign the agreement form on page 17.



EDUCATIONAL AND PROFESSIONAL INFORMATION

Please provide details regarding your educational and professional background in the Résumé section on Page 5.

Are you currently enrolled in school? Yes No If not a student, what is your current profession?

Proposed field of internship/training program:

Years of work experience related to the field of internship/training program:

APPLICANT US TRAVEL HISTORY

Are you currently in the USA on a visa or tourist waiver? Yes No

If yes, what is your intended date of departure from the USA? _____________ (MM/DD/YYYY) Attach copy of return ticket indicating departure date.

Have you ever visited, worked, lived or studied in the USA? Yes No

If Yes, please list dates, visa type, and name of program/sponsor for each trip. Attach copy of all visa(s) and tourist waivers from the past ten years. Use additional sheets to list more visas and travel dates.

DATES - MM/DD/YYYY

EXACT ARRIVAL EXACT DEPARTURE

VISA TYPE REASON FOR TRAVEL

Have you ever been denied a visa or denied entry to the USA? Yes No If yes, please explain:

Have you ever been convicted of a crime in the USA or in your home country? Yes No If yes, please explain:

APPLICANT MEDICAL HISTORY

Please state all previous or current medical conditions, hospitalizations, and surgeries:

Are you presently on any medication or seeking medical treatment? If yes, explain:

If you were previously on medication or sought medical treatment, was the medication and treatment discontinued with your doctor’s consent? Yes or No. If no, please explain:

APPLICANT’S EMERGENCY CONTACT INFORMATION

Your emergency contact must speak English. Please provide the name of a relative, spouse, or someone who knows you well.

ENGLISH SPEAKING EMERGENCY CONTACT NAME RELATIONSHIP TO APPLICANT

— — COUNTRY CODE – CITY CODE – PHONE NUMBER EMERGENCY CONTACT EMAIL ADDRESS



Résumé You must complete this form - please attach a separate sheet with any information that does not fit on this form.

PERSONAL INFORMATION

LAST NAME FIRST NAME

EDUCATIONAL BACKGROUND Please list most recent education first, excluding high school.

NAME OF ACADEMIC INSTITUTION CITY COUNTRY

- DEGREE AWARDED? Yes NoDATES ATTENDED (MM/DD/YYYY - MM/DD/YYYY) FIELD OF STUDY TYPE OF DEGREE PROGRAM Bachelor's

Master's

Certificate

OtherWEBSITE

WORK EXPERIENCE Please list most recent experience first.

COMPANY NAME JOB TITLE

- CITY COUNTRY DATES OF EMPLOYMENT (MM/DD/YYYY - MM/DD/YYYY)

Descriptions of Roles and Responsibilities (list as bullet points):






Master's

Certificate

OtherWEBSITE



Master's

Certificate

OtherWEBSITE



WORK EXPERIENCE Please list most recent experience first.







SKILLS

Beginner Intermediate Advanced Fluent Native

LANGUAGE LEVEL OF PROFICIENCY





Computer/Technical Skills (Please include knowledge of software programs - e.g., Adobe Photoshop):

Certifications/Relevant Coursework:

Other skills related to industry in which you are seeking an Intership (Please include emberships to any professional organizations):



INTERNSHIP/TRAINING OBJECTIVES

1. Why are you qualified to participate in an internship/training program in the U.S.? Discuss education, work experience, and preparations you have undertaken.

2. What skills and knowledge do you expect to gain during each of the phases of your internship/training in the U.S.?

3. How would successful completion of an internship/training program in the U.S. assist you in your future?



Interns and Trainees must have sufficient funds to support themselves for their entire stay in the USA. Please estimate the amount of money you will need upon arrival, as well as your expected monthly expenses. You may consult your host employer for information about the cost of living in their area.

STIPEND/SALARY $______________per________

(HOUR, DAY, MONTH, ETC.)

Have you already secured housing? Yes No

Will you be paying for housing in the USA? Yes No

If no:

Paid for by employer

Living with friend/family member

Other Please explain:

Will you be paying for transportation costs in the USA? Yes No

If no:

Paid for by employer

No transportation costs necessary to commute from housing to employer

Other Please explain:

Cost of Living Worksheet

MONTHLY EXPENSES

Monthly rent

Food & other groceries

Commuting costs (e.g., gas, parking, tolls, bus, subway)

Laundry/Dry cleaning

Internet

Phone

Utilities (e.g., water, heat, electricity)

Other (cable, medicine)

Total monthly expenses

ONE-TIME EXPENSES (These are costs you may incur upon arrival in the United States)

Hotel upon arrival

Furniture/Housewares

Security deposit for an apartment (usually equivalent to one month rent. May require last month rent as well.)

Total one-time expenses



Proof of Sufficient FundsPlease select the appropriate option below. If applicants are supporting themselves, they should include their stipend/salary provided by their employer (if applicable), as well as their own available personal funds in the monthly amount stated below.

OPTION 1:

Applicant Supporting Self

I certify that I have the amount of $ (USD) per month available to support myself during my internship/training program in the U.S. I have attached proof of my available funds.

Applicant's Handwritten Signature Date

OPTION 2:

Applicant Supported by Parent/Guardian/Spouse/Current Employer in Home Country

Name:

Relationship to Applicant:

I certify that I have the amount of $ (USD) per month available to support

while he/she is completing an internship/training program in the U.S. (applicant’s full name)

I have attached proof of my available funds.

Handwritten Signature Date

CT–PA01–1212 Page 10 of 17


CAREER TRAINING USAFee Payment Information

Participant Name: Program Length: months LAST NAME FIRST NAME

Program Fee Due: $

Dependent Fee Due (if applicable): $

Host Employer Site Visit Fee (if not being paid by employer): $

Total Fees Due: $

I/we specifically authorize InterExchange to charge US$ for the Career Training USA Program to my/our (check one):

Card Type: Visa MasterCard American Express Discover

Card Number: — — —Security Code:

Exp. Date: MM/YYYY

Name as it appears on the card:

Billing Address:STREET ADDRESS

CITY STATE/PROVINCE ZIP/POSTAL CODE COUNTRY

I authorize InterExchange, Inc. to charge my credit card according to the details above.

I certify that I have reviewed and agree to the InterExchange Career Training USA Fee & Refund Schedule.

Please sign below.

Credit/Debit Card Holder’s Signature: Date: MM/DD/YYYY

Thank you!

Payment is accepted by:

1 Check or Money Order drawn on a U.S. bank account in U.S. dollars, payable to InterExchange, Inc.

2 Credit Card (Visa, MasterCard, American Express or Discover)

•Online (preferred method) at http://www3.interexchange.org/payonline/

• By email, fax or mail: Fill in the form below for credit card authorization. Please return this form to InterExchange via email, fax or mail.

Email: [email protected]

Fax: (212) 924-0575, ATTN: Finance Department

Mail: InterExchange, Inc. Career Training USA Program 161 Sixth Avenue, 10th Floor New York, NY 10013

http://www3.interexchange.org/payonline


CT–PA01–1212 Page 11 of 17


INTEREXCHANGE, INC. Career Training USA Participant AgreementThis Agreement by and between InterExchange, Inc., a 501(c) (3) organization located at 161 Sixth Avenue, New York, NY 10013, and me as a Participant (herein “Participant”) defines the terms and conditions between InterExchange and myself regarding InterExchange’s Sponsorship of my J-1 Visa for the Exchange Visitor Program, which involves a Host Employer providing professional training to me. I understand that my training will be in compliance with the terms and conditions set forth in an approved Training/Internship Placement Plan.

BACKGROUNDInterExchange is a designated Sponsor of the J-1 Intern and Trainee Visa Programs administered by the U.S. Department of State’s Bureau of Educational and Cultural Affairs. The Cultural Exchange Program allows InterExchange Intern or Trainee Participants to gain practical training experience in their academic or occupational field with an appropriate American Host Employer for up to twelve (12) to eighteen (18) months as determined by U.S. Department of State Program Regulations. I agree to the following terms and conditions of the Program:1. Definitions. The definitions for this Agreement are set forth in the document labeled “Career

Training USA Definitions”, which can be found in the Career Training Resource Center at the following URL:

http://www.interexchange.org/career-training-usa/internship-co-op-trainee-job/resources By signing this Agreement, I certify that I read, understood and agree to the terms in Career

Training USA Definitions.2. Objective. I agree that InterExchange’s Career Training USA Program exists to enhance my

skills and expertise in my academic or occupational field through participation in a structured and guided work-based Training or Internship Program and to improve my knowledge of American techniques and methodologies. Such Training and Internship Programs are also intended to increase my understanding of American culture and society and to enhance American knowledge of foreign cultures and skills through an open interchange of ideas between myself and my American associates. I agree to comply with the goals, objectives, Regulations, and policies of the J-1 Intern/Trainee Exchange Visitor Program (22 CFR Part 62.22) throughout the duration of the Program. I further understand that any conflict between the cultural exchange purposes of the Career Training USA Program and my duties as an Intern or Trainee shall be decided in favor of the cultural exchange purposes of the Program.

3. Application, Interview, Selection & Decision Process a. Application. I agree to the following terms and conditions:

(i) Application. I agree to complete the Application as required by InterExchange and Program Regulations. I understand that the Application is incorporated into this Agreement. Upon submission, I agree that my Application is the property of InterExchange. I agree that original documents shall not be returned. I understand that I may request copies of materials submitted with my original Application provided, however, that I submit a notarized request specifying the documents requested. I understand that such requests may only be fulfilled within one year of my Application submission date.

(ii) Background Information. In compliance with the Background Information section of the Agreement, I understand that background information in the Application about myself is obtained for the sole purpose of determining my suitability for the Program.

(iii) Additional Application Documentation. I agree that InterExchange, at its sole discretion, may request additional documentation in order to make a final decision about my Application.

(iv) Complete Application & Review Time. I understand that I must provide a complete Application and make full payment before InterExchange is required to render a decision to grant or deny Sponsorship. I understand that Application review timelines are estimates only, and I understand that the review is subject to receipt of appropriate documentation as determined by InterExchange.

(v) Circumstances that may negate Application. I agree not to apply for InterExchange’s J-1 Visa Sponsorship if any of the following is true:

a. I reside in the U. S. I agree to apply for the J-1 Visa from outside the United States.

b. I require a change of status from another U.S. government issued visa to the J-1 Visa.

c. I intend to train as an au pair, childcare giver, teacher, teaching assistant, camp counselor, ship or aircraft crew member, or a medical staff having patient contact.

d. I do not intend to leave the U.S. upon successful completion of my J-1 Intern/Trainee Program.

e. I started my own company within the U.S., and I will use the J-1 Visa to work for the company.

f. I intend to violate the Regulations of the Program or laws of the U. S.g. I have a serious illness or condition (e.g., an illness that requires surgery or

ongoing therapeutic care) that will inhibit my ability to successfully fulfill the terms of this Exchange Visitor Program and/or jeopardize my wellbeing.

(vi) Visa Status and Application. I understand that a failure to accurately report my visa status to InterExchange shall result in the rejection of my Application. If Sponsorship was granted prior to the discovery of violation(s) of InterExchange policy, InterExchange shall withdraw Sponsorship at the time of discovery and no refund shall be granted.

b. Third Parties (e.g., attorneys). I may apply to the Career Training USA Program without an attorney or assistance from a Third Party. Any fees or costs associated with the use of a Third Party are my responsibility. InterExchange is not responsible for the conduct of the Third Party. I must inform InterExchange of any relationship with Third Parties. In order for a Third Party to inquire about my Application or Program status, I must grant power of attorney to the Third Party, and I must provide written notice to InterExchange before InterExchange will speak about either my Application or status.

c. Final Decision. I understand that InterExchange reserves the right to reject me as an Applicant, my potential Host Employer, or my proposed Training/Internship Plan as described under my DS-7002 Form if InterExchange determines, at its sole discretion, that either a party or the Training/Internship Placement Plan does not meet the requirements and objectives of the Regulations or InterExchange Program guidelines.

d. U.S. Embassy or Consulate. I understand that InterExchange has no control over the actions or decisions of the U.S. embassy or consulate in my country of residence regarding issuing the J-1 Visa. The decision is at the sole discretion of the embassy/consulate. In compliance with the terms of this Agreement, I understand that I must provide truthful responses during my interview and in all dealings with the U.S. government.

4. Program a. Position

(i) Training/Internship Placement Plan. I understand all Host Employers must complete a Training/Internship Plan that is unique to my training goals and qualifications. I further understand the Host Employer, Intern/Trainee, and InterExchange must sign the Training/Internship Plan DS-7002 Form to formally execute the document, which will be presented to the embassy/consulate during the visa interview. Subject to the terms and conditions of this Agreement, I must notify InterExchange immediately if the Training/Internship Plan changes or is not followed according to its terms.

(ii) Limitations on Training/Internship Program. I agree to the following terms and conditions:

a. The Intern/Trainee J-1 Visa Program is not intended to be a substitute for ordinary work purposes, and it is not intended under any circumstance to displace American workers, or be a conduit to permanent work and residency in the USA.

b. I must not perform a Training/Internship Program that includes more than twenty percent (20%) of basic and/or Clerical tasks. The purpose of this Program is to perform professional tasks and responsibilities and not Unskilled, Manual, or Casual Labor.

c. I must not intern or train in child care or elder care, or in clinical or any other kind of work that involves patient care or patient contact, including any work that would require Trainees or Interns to provide therapy, medication, or other clinical or medical care (e.g., sports or physical therapy, psychological counseling, nursing, dentistry, veterinary medicine, social work, speech therapy, early childhood education).

d. For Hospitality placements lasting six months or longer, I agree that the Training/Internship Plan must provide a minimum of three departmental or functional rotations.

b. Cultural Exchange Events. I agree to attend Cultural Exchange Events that will provide me with exposure to the societal, cultural and historical elements as well as values of the U.S. I agree to provide evidence that I attended Cultural Exchange Events in the U.S. and will describe my Cultural Exchange Events as a part of the Evaluation Forms (see below) that I am required to complete for the Program.

c. Work Hours. I must pursue a full-time position (thirty-two (32) hours/week minimum) as an Intern/Trainee. I understand that there is not an upper limit on the number of hours that a Host Employer may assign me and that details regarding compensation for work hours must be discussed and agreed to by my Host Employer and myself prior to submitting the Program Application. I understand that all terms and conditions must be compliant with the requirements of U.S. labor and employment laws. I further understand a failure to perform the terms of this clause shall be grounds for ending the Program and revoking my Sponsorship by InterExchange.

d. Length of Program & Visa. I understand and agree that my Program participation begins on the day of my arrival into the U.S. and ends on the day of my departure from the U.S. so long as this occurs within the legal Program dates as defined by my DS-2019 Form and that I am in compliance with the rules and Regulations of the Program. I may arrive up to a maximum of 30 days prior to the program begin date on my DS-2019 Form, but I may not begin my training until the begin date on my DS-2019 Form. The thirty (30) days after the Program end date is my 30-Day Travel/Grace Period as defined in this Agreement. I shall not leave and re-enter the U.S. during the 30-Travel/Grace Period without first obtaining proper immigration documentation. I agree to the specific terms of the length of my Program as follows:(i) If I am a Trainee, my training must not exceed eighteen (18) months, or, in the case

of Hospitality and Tourism, it must not exceed twelve (12) months, but, in either case, may be as short as one (1) month. I agree to only legally train with my Host Employer within the Program begin and end dates listed on my DS-2019 Form.

(ii) If I am an Intern, my Internship must not exceed a maximum of twelve (12) months but may be as short as one (1) month. I agree to only legally intern with my Host Employer within the Program begin and end dates listed on my DS-2019 Form.

(iii) If I am either a Trainee or an Intern, I must not leave the United States for more than thirty (30) consecutive days once the Program begins.

(iv) If I am either a Trainee or an Intern, I must leave the United States within thirty (30) days of quitting or being fired if I do not locate a new Host Employer under the terms and conditions set forth in this Agreement, including, without limitation, the submission and approval of a new Training/Internship Placement Plan prior to starting a new Intern/Trainee position. I understand that I must leave the U.S. immediately if InterExchange ends my Sponsorship.

(v) I must verify that all the details on my DS-2019 Form are accurate prior to attending my visa interview at the Embassy or Consulate. If I discover that any of the information is incorrect, I must return the incorrect DS-2019 Form to Career Training USA, who will issue an updated DS-2019 Form. I understand that the time it may take to print and ship the DS-2019 Form may vary and visa appointments may need to be rescheduled at my own cost.

e. Visa. I must complete all visa requirements in accordance with the instructions provided by the Embassy or Consulate at which I am applying and InterExchange (if any).

f. Passport. I must hold a passport that is valid for six (6) months beyond the Program end date.

http://www.interexchange.org/career-training-usa/internship-co-op-trainee-job/resources

CT–PA01–1212 Page 12 of 17


g. Vaccination & Immunization. I must comply with all vaccination and immunization requirements.

h. Student and Exchange Visitor Information System (SEVIS). I must register with SEVIS in the manner described under the notice terms and conditions of this Agreement. I must read the terms and conditions carefully to understand the ramifications of failing to properly register with SEVIS.

i. Housing. I agree to thoroughly investigate housing costs, the suitability of the area and living conditions of housing during my Training/Internship program, and the mode of transportation that I will be required to take. I must not wire money to unknown sources. I shall take responsibility for fully understanding the terms and conditions of any leases that I sign, including, without limitation, the duration of the lease and any penalties for breaking the lease.

j. English Language Proficiency I certify that I have the ability to communicate proficiently in English. I understand that I will be subject to English language screening, and I must complete an interview in English. I must possess English language skills sufficient to meet the goals of my Training/Internship Placement Plan and to understand and exercise my rights within the U.S.

k. Sufficient Funds. I must provide proof of sufficient funds to support my Dependents and myself throughout the duration of the Program. I understand that the funds must be sufficient for the cost of living in the geographic location of my Training or Internship position and agree to research whether I have sufficient funds in advance of my arrival into the United States.

l. Insurance. (i) I agree to the terms and conditions of the Insurance policy arranged through the

vendor authorized by InterExchange. I understand that InterExchange requires that I receive the Insurance policy through the authorized vendor for the purpose of meeting or exceeding the U.S. Department of State Regulations as found in 22 CFR Subpart A. I further understand that the Insurance coverage is not comprehensive. In compliance with the Supplemental Insurance clause below, I understand it is my responsibility to maintain any additional Insurance that I may need. In addition, I understand that InterExchange is neither a seller nor reseller of Insurance. For additional information about the Insurance policy from InterExchange, I agree that I must read the terms and conditions of the policy in the brochure and literature sent to me by InterExchange and visit InterExchange’s web site documentation about the policy located on the following web page:


I understand that InterExchange reserves the right to change Insurance provider with or without notice at any time during my Program.

(ii) Insurance Coverage Dates. I understand the importance of having Insurance coverage for the duration of my Program and my stay in the U.S. If I arrive or plan to arrive in the U.S. before the Program start date, I must make the arrival date known to InterExchange in writing (e.g., via e-mail) immediately. I understand that a failure to notify InterExchange may result in a lack of coverage during my stay in the U.S. I understand and agree that InterExchange may require that I purchase additional Insurance to cover early arrival dates. Pursuant to the Liability Section of this Agreement, I agree that InterExchange cannot be held responsible for any claim made outside of the Insurance dates.

(i) Supplemental Insurance. I understand that InterExchange’s involvement in my Insurance coverage is limited to InterExchange’s determination that the approved or authorized policy complies with U.S. Department of State Regulations for accident and medical sickness Insurance. I understand that the approved policy may contain exclusions and may not cover pre-existing conditions. I agree to investigate my policy, and InterExchange strongly recommends, that I obtain supplemental insurance to meet any medical and travel coverage needs not met by the Insurance referenced herein for the duration of the Program. If the Host Employer promises to provide me with coverage to supplement Insurance, and the Host Employer later denies me coverage during my Program with the Host Employer, I agree to provide written notice to InterExchange of the changes.

m. Worker’s Compensation & Insurance. Unless otherwise stated in writing by the Host Employer, I understand that the Host Employer will provide me with Worker’s Compensation coverage for the duration of my Program with the Host Employer. If the Host Employer is exempt from Worker’s Compensation coverage, the Host Employer will make me aware of its exemption. If the Host Employer changes my Worker’s Compensation coverage during the Program, I agree to contact InterExchange in writing to provide notice. I am also under a duty to provide written notice to InterExchange about any other changes to insurance coverage offered by the Host Employer to me about which the Host Employer provides me notice.

n. Changes to Regulations and Requirements. I understand that there may be changes that apply to my Sponsorship. I agree to follow guidance from authorized InterExchange representatives regarding these changes that may be communicated to me through including, without limitation, E-mail, the InterExchange web site, and Social Media.

o. Completion of Intern/Trainee J-1 Visa Program. I agree to the following:(i) No Training/Internship. I must not continue to train or intern with my Host

Employer during the 30-Day Travel/Grace Period.(ii) I must leave the U.S. on or before the end of my 30-Day Travel/Grace Period. If an

earlier date is indicated by Customs and Border Protection on my I-94 card than the date ending my 30-Day Travel/Grace Period, I must leave on or before the date indicated on the I-94 card.

(iii) When the Program ends, I must return the DS-2019 Form to InterExchange after I return to my home country.

(iv) Evaluation Forms. My Host Employer and I must complete the following Evaluation Forms provided by InterExchange, including the details of my participation in Cultural Exchange Events:

(a) Interim Evaluation Form (if Program is six (6) months or longer).(b) Final Evaluation Form (for all Program lengths).

5. Sponsorship and Employmenta. At Will Employment Notice. I understand that the Host Employer’s Training/Internship

position is At-Will Employment.b. No Additional Employment. I must not work in any additional position, including,

without limitation, volunteer or paid employment, or internships, during the Program. I must only work with the Host Employer that has been approved by InterExchange for the duration of my Sponsorship.

c. Changes in Employment. I agree to make InterExchange aware of any changes in my employment, including, without limitation, outsourcing my employment to third parties such as employment agencies or consultants, changes in my supervision that impact my Training Plan, and other significant changes with my Host Employer of which I become aware.

d. InterExchange Is Not My Host Employer. With the exception of Trainees or Interns hired by InterExchange as temporary employees (see below), I agree that InterExchange is neither my Host Employer nor an Employment Agency. Trainees or Interns working for InterExchange shall be so indicated by an Intern-Trainee letter of temporary employment that InterExchange’s Human Resources Department sends to Trainees/Interns hired by InterExchange.

e. Sponsorship. With the exception of Trainees/Interns working for InterExchange as described in Section 5(d), I agree that InterExchange’s sole function is to Sponsor my J-1 Visa and monitor my placement to ensure my safety and well-being throughout my Program.

6. Air Travel & Transportation. I am solely responsible for all costs concerning air travel and transportation arrangements.

7. Safety, Emergencies & Problemsa. Precautions.

(i) I am responsible for my personal health and safety needs while participating in the Career Training USA Program. If I suffer from any health or other condition that would create a risk to others or myself, I must not apply to or participate in the Program.

(ii) I must take reasonable precautions to prevent injury or harm to others or myself, or damage to the property of others or myself.

(iii) I am hereby provided notice that I am required to investigate to determine whether my intended housing is safe and suitable (e.g., meet local safety code standards), and I must demonstrate that my housing is safe and suitable if InterExchange requests said evidence from me. For more information regarding the suitability of housing, I must read the information provided at the following link under Housing:


(iv) I must use safe and suitable transportation.b. I agree to the following:

(i) I must notify InterExchange in the manner required under this Agreement if I experience any serious medical, psychological, or criminal incident.

(ii) I must contact InterExchange immediately if the Host Employer endangers my safety or the safety of others or acts in a manner that raises questions about my safety or the safety of others.

(iii) To the extent that it is reasonably possible, I must stay in contact with InterExchange Program representatives during any natural disaster or emergency. If I am unable to contact or respond to InterExchange during a natural disaster or emergency, I must contact an authorized InterExchange representative to confirm my circumstances as soon as it is reasonably feasible to do so.

(iv) I must act as the point of contact between InterExchange and my J-2 Dependents (if applicable) during any natural disaster or emergency. I must also act as the point of contact for the purpose of emergency contact as described below under Emergency Contact, and I shall be responsible for ensuring the compliance of my Dependents with its terms. I understand that InterExchange may contact my Dependents directly.

(v) Emergency Messaging. In addition to following any emergency plan available to me from local authorities or the Host Employer, if I supplied my mobile number, I agree to follow suggestions as may be sent through InterExchange emergency messaging, including, without limitation, emergency texts from InterExchange. If local authorities or the Host Employer recommend actions that conflict with any messages sent via InterExchange emergency messaging, I shall follow the direction of the Host Employer or local authorities, as they may be better aware of local circumstances. I understand and agree that InterExchange is not obligated to provide me emergency messaging and that this is an additional service that InterExchange may provide to me as circumstances may permit or warrant.

c. InterExchange may take action regarding my health and safety (i) In circumstances involving my health and safety, I agree that InterExchange may

discuss my circumstances with the Host Employer, emergency contacts, the International Cooperator, my Insurance company, healthcare officials, or any other critical party.

(ii) I agree that InterExchange, its officers, employees, independent contractors, vendors affiliates, and agents or any representative authorized by InterExchange may, without liability, or expense to themselves (as explained in further detail under the Warranties, Indemnification, Limitation of Liabilities, Release and Acts of God Section), take whatever action they deem appropriate with regard to my health and safety and may place me in a hospital or health-related facility for medical services, observation and treatment or, if no hospital or health-related facility is readily available, may place me in the care of a local medical doctor or health provider for treatment, observation or services.

d. InterExchange Health and Safety (i) I understand that in the event of an accident or serious illness that, in the judgment

of InterExchange, prevents me from successfully complying with the terms and conditions of my Training/Internship Placement Plan, I will end the Program early and return home at my own expense.

(ii) If InterExchange finds that I am subject to exploitative or other unreasonable circumstances or conditions by my Host Employer, InterExchange, at InterExchange’s sole judgment, may immediately withdraw its Sponsorship of my Training/Intern position. I understand that InterExchange will seek to assist me with finding a new Training/Intern placement under which InterExchange can provide Sponsorship, but that InterExchange cannot guarantee that I will receive a new position.

(iii) I agree that InterExchange has the right to dismiss me from the Program, if, in InterExchange’s sole judgment, I am deemed to be a danger to myself or to others, or if my conduct is deemed to be detrimental to the Program in anyway.

e. Emergency instructions(i) I must become aware of emergency plans set up by the Host Employer and as

issued by local authorities.(ii) In case of emergencies (e.g., hurricanes, flooding, earthquakes, fires, terrorist

attacks), I agree to follow guidance issued by InterExchange, the Host Employer and local authorities. I agree to follow the guidance of the Host Employer and/or local authorities if the guidance conflicts with InterExchange guidance.

f. Withdrawal. I must notify InterExchange if I decide to leave the Program for any reason.

8. Extensions and Change of Host Employera. Extension. I must meet the following conditions before I may be considered for an

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(i) Application. I must submit an Extension Application thirty (30) to sixty (60) days prior to the original Program end date as indicated on the DS-2019 Form. If it is less than thirty (30) days until the end of my Program, I cannot be considered for an Extension.

(ii) Full Payment. My Extension Application must include full payment as outlined in the Career Training USA Extension Fee and Refund Schedule, which shall be determined by the schedule then in effect at the time when the complete Extension Application is submitted for review to InterExchange Career Training USA.

(iii) Insurance. I must maintain Insurance coverage under the terms and conditions described in this Agreement. I understand that the cost of Insurance is included in my Program Fees when InterExchange extends my Program.

(iv) No Guarantee of J-1 Visa Approval. I understand that approval by InterExchange is not an Extension of my J-1 Visa. My J-1 Visa may expire during the dates covered by the Extension. If I travel outside of the USA after my Visa expires, I will have to go back to the U.S. Embassy/Consulate in my home country and apply for a new J-1 Visa. The extended DS-2019 Form does not allow me to re-enter the United States if my visa has expired.

(v) Return Home. Upon completion of my Extension, I must depart the U.S. on or before the end of the Extension Program 30-Day Travel/Grace Period.

b. Early Termination from Training/Internship Position. If my Training/Internship position ends early, I agree to the following procedure:(i) If I am fired or I quit my Training/Internship position, I must notify InterExchange

no later than ten (10) days after the termination of my employment. (ii) Subject to InterExchange’s discretion and upon submission of applicable fees and

a Change of Host Application, I may seek a new Training/Internship Program and my new Host Employer may submit a Training/Internship Placement Plan and other required employment documents. I understand that the length of the time for my new Internship/Training with the new Host Employer shall match the time that I have remaining in the Program, provided, however that I have not applied for and obtained an Extension under the terms and conditions of this Agreement.

(iii) I must not work with the new Host Employer unless and until InterExchange approves the Host Employer and Training Plan.

c. Removal from Program If the Host Employer or I terminate employment, I may be asked by InterExchange to

return to my home country. 9. Fees, Cancellations, Expenses and Refunds

a. Fees. I understand and agree to the fees in the applicable InterExchange Career Training USA Fees Schedule, which shall hereby be incorporated into this Agreement in Exhibit C. I must confirm with InterExchange that I am filing my complete Application with the correct payment of fees based on the most up to date Career Training USA Fees Schedule to avoid any delays due to a lack of full payment.

b. Emergency Messaging Fee. If I provide my mobile number for emergency contact (e.g., emergency texting) from InterExchange, I agree to assume all necessary charges per carrier fees for usage that may arise if InterExchange sends emergency messaging to me.

c. Copies, Replacements or New Documents Fees. (i) If I am denied a visa and I wish to reapply at the Embassy/Consulate and require

a new DS-2019 Form reflecting revised Program dates, I agree to the cost of a reprint as indicated by the Career Training USA Program Fees.

(ii) I understand that the DS-2019 Form is a controlled document that I must hold in my possession throughout my Program, and, therefore, I shall bear the cost of replacing the DS-2019 Form if lost.

(iii) I agree that InterExchange cannot replace any other document, including, without limitation, my visa, passport or I-94. Therefore, I am responsible for replacing any document that is not the DS-2019.

d. Insurance Fee. I understand that the cost of Insurance provided by the authorized-vendor under this Agreement is included in the Program Fee.

e. Invoice. I agree that I will only receive an invoice upon my request for an invoice.f. Refund Policy. I agree to the refund policy as outlined within the applicable Career

Training USA Program Fee Schedule. g. Additional Costs. I agree that InterExchange cannot be held responsible for any

additional costs to me due to, without limitation, delays in submitting documentation or delays by the U.S. embassy in issuing a visa. Moreover, InterExchange strongly advises that I not to book a flight or sign a lease until I secure my visa, since InterExchange cannot be held responsible for the cost of rebooking or cancelling a flight or renegotiating lease terms with landlords due to delays in processing or visa rejections.

h. Visa Fees. I must pay the local visa fee to the U.S. Embassy. I am responsible for any additional visa fees that might apply at the U.S. Embassy or the U.S. Consulate in the country where I am applying for the visa.

10. Communication and Noticea. I must direct all electronic communication to InterExchange at training@interexchange.

org. I must include the above email address in my e-mail address book to ensure receipt of communications from InterExchange. In the case of an emergency, I agree to contact InterExchange as soon as reasonably possible.

b. InterExchange will contact me at the email address that I provided in the InterExchange Career Training USA Application. I agree to respond to communications from InterExchange in a timely manner.

c. I am responsible for acting as the point of contact for Dependents, but I understand that InterExchange may contact my Dependents as necessary throughout the duration of the Program.

d. Emergency Messaging. For the purpose of emergency messaging, I agree that InterExchange may contact me via text message and/or voice services through my mobile phone and/or by email.

e. Specific Circumstances Requiring Notice. In addition to the general notice requirements set forth under this Agreement, I must provide notice to InterExchange under the following circumstances: (i) SEVIS Reporting. Within ten (10) days of arrival into the U.S, I must provide

InterExchange with my address, telephone number, and e-mail address for the purpose of registering into SEVIS. I understand that the consequences of not reporting to SEVIS may include, without limitation, InterExchange ending my Program or the U.S. Department of State detaining and/or deporting me for immigration violations.

(ii) Within 10 days of any changes in address, telephone number, or email address that differs from the information that I provided to InterExchange for SEVIS.

(iii) Any trips that I plan to take outside the USA. I also understand that I must have InterExchange sign my DS-2019 Form prior to taking a trip outside the USA and that the signature is valid for six (6) months only.

(iv) My Training/Internship Program ends or if I leave my Host Employer for any reason.

(v) I have been hospitalized or if I have been afflicted with a medical or mental health condition that temporarily suspends or will not permit me to complete my Program.

(vi) I have been arrested or have been a victim or perpetrator of a crime while participating in the Program.

11. Release, Intellectual Property, Social Media & Disreputea. Release

(i) I give permission to InterExchange to (i) take and retain any photographs (including group photos), copies of images from passports, videos, audio recordings and other depictions of me (collectively, the “Reproductions”) during activities associated with InterExchange; (ii) retain any Reproductions that I submit to InterExchange, or that I post on any InterExchange-branded or InterExchange-affiliated media site, social networking site or video upload site or “channel” or blog, including, without limitation, Facebook, LinkedIn, YouTube, Twitter, or any other electronic site; and (iii) publish, distribute and display, either in whole or in part, any Reproductions in any and all media throughout the world, including, without limitation, media sites, social networking sites, video upload sites or “channels,” blogs, electronic postings, calendars, brochures, advertisements and other promotional materials.

(ii) I hereby waive compensation and any right to inspect or approve any such uses and Reproductions. I must not submit any Reproduction unless I first obtained permission from each person whose name, image, voice, or likeness is included in the Reproduction, and each such person has granted me and InterExchange all copyright and other intellectual property rights, including renewal rights, necessary to use the Reproduction and his or her name, image, voice and likeness in it. I hereby release, discharge and agree to hold InterExchange harmless from any liability arising out of InterExchange’s use of the Reproductions, including any blurring, distortion, alteration, optical illusion or use in composite form with other works. I hereby assign all copyright and other intellectual property rights, including renewal rights, to InterExchange, in any materials produced that are the subject of this Release.

b. Use of InterExchange Intellectual Property. If I desire to use InterExchange Intellectual Property for any reason, I must contact InterExchange’s Marketing Department to request permission. I must not use InterExchange’s Intellectual Property without having obtained prior written permission. InterExchange Intellectual Property shall include content from InterExchange’s Social Media, copyrights, trademarks, logos and any content owned by InterExchange. When in doubt, I understand the best policy is to contact InterExchange to confirm that my use of intellectual property is acceptable to InterExchange.

c. Disrepute. I must not act in a manner that brings InterExchange, the Exchange Visitor Program or the State Department into notoriety or disrepute

d. Social Media Policy. By signing this Agreement, I agree to the terms and conditions of the Participant Social Media Policy set forth under the document labeled “Participant Social Media Policy,” which is located in the Career Training USA Resource Center at the following URL:


12. Privacy and Background Checka. Privacy.

(v) InterExchange Privacy Policy. By signing below, I accept and agree to be bound by InterExchange’s Privacy Policy pursuant to InterExchange's Terms of Use located at www.InterExchange.org/terms-use (link also located in the Career Training USA Resources Center), its Privacy Policy located at www.InterExchange.org/privacy-policy (link also located in Career Training USA Resources Center), my Application and the terms and conditions set forth in this Agreement. I agree that I read each of these documents, which (if applicable) are incorporated herein by this reference, as they form a legal agreement between InterExchange and myself regarding the Privacy Policy of the Program. I understand that in the event of any conflict between the Application, this Agreement and those of the Terms of Use and Privacy Policy, the Terms of Use and Privacy Policy shall supersede with regard to the Privacy Policy.

(vi) Participants’ duty to provide privacy. In addition to the specific requirement for Social Media listed under this Agreement, I agree to protect the privacy of any party in a relationship with InterExchange and/or Career Training USA, including, without limitation, InterExchange staff. If I have questions about my duties under this clause of the Agreement, I shall contact an authorized InterExchange manager for guidance.

b. Background Information. (vii) InterExchange. I agree that the Background Information Notice is incorporated

into this Agreement in Exhibit B. The Background Information Usage Notice authorizes InterExchange to use background information (e.g., police reports and references obtained by me) for the purpose of determining my suitability for the Career Training USA Program. By signing this Agreement, I certify that I understand and agree to the purpose for which InterExchange uses the background information. By signing this Agreement, I further certify that I agree to the methods by which InterExchange procures the background information.

(viii) Host Employer. I understand and agree that the Host Employer may request additional screening of me at the Host Employer’s own expense, and that InterExchange is not responsible for any actions taken by the Host Employer. I understand that the Host Employer must conduct such investigation pursuant to the laws of the U.S. and state and local laws in which the Host Employer conduct its business.

13. Additional Agreement Termsa. Entire Agreement. I understand that this Agreement contains the entire understanding

of the parties with respect to the matters contained herein and supersedes any previous agreements (oral, written or otherwise) and may be altered or amended only by a written instrument duly executed by both parties hereto.

b. Incorporated Documents. I understand and agree that 22 CFR 62 (Exchange Visitor Program Regulations), the Wilberforce Brochure (if applicable and see also “Dispute Process”) as located on InterExchange’s website located at http://www.interexchange.org/career-training-usa/internship-co-op-trainee-job/resources, and the Extension





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Term Sheet (if applicable and as described in this Agreement) are incorporated into this Agreement. With regard to the use of InterExchange’s website located at www.InterExchange.org (“Site”), I understand and agree that I must follow terms and conditions of www.InterExchange.org/terms-use and www.InterExchange.org/privacy-policy, which are incorporated into this Agreement for the purpose of Privacy Policy and site use only rather than for the general terms and conditions of the Program. Unless required by law or regulation (e.g., required 22 CFR Part 62, Wilberforce, the Department of State or federal, state or foreign law) or involving InterExchange’s Privacy Policy, if there is a conflict between this Agreement and other documents incorporated into this Agreement, the Agreement shall be controlling.

c. Agreement in English. This Agreement and correspondence between InterExchange and myself shall be written in English. In the case of any disputes between the parties, the language that shall govern interpreting this Agreement or any issue arising out of communications, including, without limitation, correspondence, shall be English.

d. Assignment. This Agreement is restricted solely to myself and shall not be assigned, transferred, encumbered, or subject to any third party agreement without the written consent of InterExchange. Any attempted assignment will be void and of no effect. InterExchange may assign this Agreement to a successor (whether by merger, a sale of all or a significant portion of its assets, a sale of a controlling interest of the company or otherwise), which agrees in writing to assume InterExchange’s obligations under this Agreement.

e. Waiver. I agree that InterExchange’s failure to enforce any provision of this Agreement shall not be construed as a waiver or limitation of InterExchange’s right to subsequently enforce and compel strict compliance with each and every provision of this Agreement.

f. Void Provision. If any provision of this Agreement is held to be void or contrary to law, I understand that such provision shall be construed as nearly as possible to reflect the intention of the parties, with the other provisions remaining in full force and effect.

g. Headings. I agree that all headings are for purposes of convenience only and are not to be used in interpretation or enforcement of this Agreement. Terms defined in the singular have the same meaning in the plural and vice versa.

h. Third Parties. Unless otherwise expressly stated in this Agreement, I agree that the terms and conditions of this Agreement, express or implied, exist only for the benefit of the parties to this Agreement. No other person or entity will be deemed to be a third party beneficiary of this Agreement. Any contracts that are required by any party other than InterExchange are signed at my own risk as a Participant and are agreements between the Third Party and me for which InterExchange is not liable.

i. Prior Agreements. Any prior agreement between Participant and InterExchange is hereby amended by this Agreement, and, as between this Agreement and the prior agreement, this Agreement shall be controlling between the parties. The prior Agreement shall remain in effect if prior terms do not conflict with this Agreement.

j. Change of Sponsor. I understand and agree that InterExchange does not facilitate a request to change sponsors during the Program. I understand and agree that if I terminate this Agreement or otherwise end my Program that I am to return to my home country rather than stay in the U.S.

14. Laws, Regulations and Culturea. U.S. State Department Regulations. I acknowledge and agree that I am participating in

a Cultural Exchange Program and agree to comply with all of the Regulations published by U. S. Department of State 22 CFR Sec. 62, which may be amended from time to time in the future. I further agree to meet my obligation regarding SEVIS compliance and the accuracy of the information that I provide as required by the Regulations and in compliance with the terms of this Agreement. I acknowledge receipt of a copy of 22 CFR Sec. 62.22, which can be viewed at the following URL:


b. I must comply with federal, state, and local laws of the U.S., including income tax filing requirements. I am responsible for reading and carefully considering all materials made available to me that relate to safety, health, legal, environmental, political, culture and religious customs and conditions in the U.S.

c. I understand InterExchange’s notice that I am considered a non-resident alien who is not subject to Social Security (FICA), Medicare, or federal unemployment (FUTA) withholding taxes. I understand that this information is provided for notice only.

d. I must comply with all of InterExchange’s polices, rules, and procedures, as outlined in this Agreement, the InterExchange website, and any further documents, materials, and communications that I may receive from InterExchange with regard to my participation and obligations for this J-1 Intern/Trainee Visa Program

15. Warranties, Indemnification, Limitation of Liabilities, Release and Acts of God.a. No Guarantee of Training/Internship or Participation. I agree that InterExchange does

not guarantee a Training or Internship position with any Host Employer or participation in the Program.

b. No Guarantee of Satisfaction or Suitability. I agree that InterExchange does not guarantee satisfaction or suitability with the Program, the Training or Internship position, Host Employer, or the cultural exchange experience of living in the U.S.

c. Information Provided “As Is” Without Warranty or Guarantees. I agree that any information (e.g., tax and labor law requirements and emergency information and plans) communicated by InterExchange to me is provided “as is” without warranties or guarantees either expressed or implied that information is “up to date”, correct and/or accurate.

d. Participant General Liability. I waive and release InterExchange from any and all claims for contract damages, torts arising out of or concerning my employment with the Host Employer and any liability that I incur that arise out of or concerning my participation in the Program, including, without limitation, any lost, stolen or damaged property and/or any bodily injuries that harms a third party or me.

e. Limitation of Liability. If a court, government agency or legal authority finds that InterExchange has a duty under foreign or U.S. federal, state or local law, I understand and agree that InterExchange’s liability (if any) shall be no greater than its role as a nonprofit sponsor under the U.S Department of State regulations. I agree that nothing herein described in this paragraph or in the Agreement creates a duty or obligation under the law, and that the language written herein is provided solely for the purpose of limiting liability to InterExchange’s role as my Sponsor. I further agree that InterExchange’s liability is subject to the limitations set forth in separate paragraphs described in Section 15.

f. Specific Liability.(i) Expenses. I am responsible for all my personal debts, including, without limitation,

phone calls, rent, gym memberships, medical expenses, and Insurance co-pay or uncovered exclusions. I agree that InterExchange shall not be liable for any personal bills incurred by me during the Program. I agree that I am responsible directly to the Host Employer or other third parties with whom I have established a

contractual relationship for all personal debts including without limitation, phone calls and gym memberships.

(ii) Transportation. I agree not to hold InterExchange, its officers, affiliates, independent contractors, agents and employees liable for arranging transportation in the Program, and I agree not to hold any of them liable in connection with any loss, damage, personal injury, delay or expense suffered or incurred by me, resulting from any act or omission of any carrier, the Host Employer or any other body, corporate or non-corporate entity, in relation to transportation to and from and within the United States, my duties as an Trainee/Intern or any other facility or service organized on my behalf.

(iii) Specific Liabilities. I agree that I am responsible, and that I shall hold InterExchange as not liable or responsible for any claims, liability, damages or costs incurred by reason of any breach, act, error, negligence or omission that arises out of or concerns, without limitation, the following:

a. The performance of my duties as an Trainee or Internb. Risks associated with any delay in my J-1 Visa Program that arise out of or

concerns the DS-2019 Form. c. Decisions and actions carried out by the Host Employerd. Section 7(c)(i) and (ii), which respectively address InterExchange discussing

health and safety circumstances with third parties and taking action on my behalf in case of health or safety emergencies. Although InterExchange may elect to act as set forth in Section 7(c)(i) and (ii), I agree that InterExchange is not liable if InterExchange fails to act. I agree that neither Section 7(c)(i) and (ii) nor any other term under the Agreement creates an affirmative duty, either expressed or implied, for InterExchange to act. In compliance with Section 7(c)(i) and (ii), I agree that InterExchange is not liable for acting on my behalf under the circumstances described in Section 7(c)(i) and (ii).

e. Obtain housing as required under the terms and conditions of this Agreementf. Insurance (including car insurance for vehicles) or medical, dental and health

care needs that I may have during the Program.g. Any exclusions not covered by my Insurance or car insuranceh. My failure to meet immigration status requirements while in Program (e.g.,

travel outside of U.S. with expired J-1 Visa) i. My failure to follow emergency and safety rules suggested or required by

InterExchange, the Host Employer or local authoritiesj. My disclosure of information and/or documents to unauthorized parties (e.g.,

tax payer ID number or passport)k. My failure to apply for and obtain necessary documentation and information

as described in this Agreementl. Inadvertent disclosure to third parties in the course of conducting an

investigation involving my well-being or suitability for the Program.m. Breaching any other term of this Agreement (e.g., failure to follow laws of the

U.S. or guidance from states and local authorities). n. Errors in Application, government required forms (e.g., DS-2019 Form), SEVIS

information, and biographical information.g. Act of God. I agree that InterExchange and/or its officers, employees,

independent contractors, and agents are neither responsible nor liable for any events beyond their control, including, without limitation, Government restrictions that may interfere with or preclude operation of the Program; any events directly or indirectly caused by any intentional or negligent acts or omissions by the Host Employer or those with whom I come into contact as a consequence of participating in the Program; the necessity of returning me to my home country early or ending my Program early due to health reasons, transportation (e.g., air travel); terrorism; wars; and natural disasters.

h. Indemnification. I shall indemnify, without limitation, InterExchange, its officers, employees, agents, independent contractors, and organizations affiliated with InterExchange, against any loss or damage suffered by any of them, or any claims made against any of them as a result of any breach, act, error, omission or negligence by me during my participation in the Program and for the duration of my stay in the U.S.

16. Disputesa. Complaints Procedure. I and concerned third parties have the right to contact

the U.S. Department of State regarding any serious allegation arising under the Wilberforce Anti-trafficking requirement as set forth in the Wilberforce brochure that I received from InterExchange or upon refusal of InterExchange to address claims. I also understand that InterExchange will investigate allegations about my progress, well-being and suitability in the Program as directed by management of the Bureau of Educational Cultural Affairs. I understand that InterExchange will not divulge any background information about me other than the information required to respond to the request for investigation.

b. In the event that I wish to lodge a complaint about any services provided by InterExchange, its suppliers, agent, representatives, independent contractors, vendors and/or affiliates (e.g., Insurance vendor, Host Employer, International Cooperator, or anyone in a relationship with InterExchange), I must first notify an authorized InterExchange manager in writing in order to give InterExchange the chance to rectify the problem.

c. I understand and agree the laws of the state of New York govern this Agreement. d. I agree that any controversy, dispute or claim arising out of or in connection with

this Agreement, the relationship of the parties, or its interpretation, performance or nonperformance, or any breach thereof shall be determined solely in arbitration conducted in New York City in accordance with the then existing rules of the American Arbitration Association.

e. Cost of Arbitration. In the event of arbitration as described in 16(d), I understand and agree that the non-prevailing party must reimburse the substantially prevailing party for all reasonable attorneys’ fees, expenses incurred in bringing or defending the action and costs resulting or arising out the litigation.

f. Cost of Litigation. In the event that a court or legal authority fails to enforce the arbitration clause set forth in 16(d), I understand and agree that the non-prevailing party shall reimburse the substantially prevailing party for all reasonable attorneys’ fees, expenses incurred in bringing or defending the action and costs resulting or arising out the litigation.

17. Term and Terminationa. This Agreement shall be effective as of the submission of any part of the Application

(the “Effective Date”). The Agreement shall automatically terminate upon the completion of the Program and departure of Dependents and myself from the United States.

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b. Either party may terminate this Agreement at any time. Either party may terminate this Agreement immediately in the case of serious breach by a party as solely determined by the party claiming such breach, which has not been remedied within one month after a substantiated, written request has been sent to the breaching party.

c. InterExchange is Sponsor designated by the U.S. Department of State of the Internship/Training J-1 Visa Program and InterExchange may at any time withdraw my Sponsorship for any reason including, but not limited to criminal conduct, mental illness, discovery of fraudulent information submitted in my Application, non-compliance with Program Regulations (22 CFR Part 62.22), or InterExchange’s program rules and policies, or due to any deviation from the Training/Internship Plan (Form DS-7002) that is not in line with program regulations and InterExchange’s program rules and polices. In the event of my Sponsorship ending, this Agreement shall terminate effective upon the date of status change within SEVIS.

d. I understand and agree that if I leave the U.S. for more than 30 days that my Sponsorship shall end and this Agreement shall automatically terminate.

e. Survivorship. I agree that the terms and conditions regarding definitions, liability, fees, privacy, releases, intellectual property, Social Media, reputation, confidentiality and expenses/costs shall survive the termination of this Agreement

18. Full Disclosure. I agree that I am solely responsible for the accuracy and full disclosure of any information provided my dependents, myself or a Third Party representing us and agree to keep information accurate and up to date. I confirm that the information that I provided is true, complete and accurate, and upon request I will provide any additional documentation necessary to participate in this Program.

19. Dependents. I understand that I am permitted to bring Dependents with me under the Program as J-2 Visa holders. J-2 Visa Dependents may be a spouse and/or unmarried children under the age of 21. J-2 Visa Dependents must be approved by InterExchange, which is the Sponsor of the Dependent. If a Dependent is a Minor Child Dependent, I hereby certify that I have the authority to act as the legal guardian of the Minor Child Dependent, to sign agreements for the Minor Child Dependent, and otherwise to act on behalf of the Minor Child Dependent during their stay in the U.S. and participation in the Program, and I agree to ensure the Minor Child Dependent’s compliance with the rules and Regulations of the Program, the terms and conditions of this Agreement, and U.S. federal, state, and local laws. If Dependent is an Adult Dependent, I understand that the Adult Dependent must sign a separate agreement that states (a) that the Adult Dependent must comply with the rules and Regulations of the Program, the terms and condition of this Agreement, and U.S. federal, state and local laws; and (b) sets forth additional terms and conditions applicable to the Adult Dependent. Except for the rules and Regulations specifically defining the J-1 Visa holder’s Internship or Training, Dependents and I agree that the terms and conditions of this Agreement shall generally be applicable to Dependents. Dependents and I further agree that InterExchange shall make the final determination during the administration of the Program about which terms and conditions under the Agreement that are applicable to Dependents.

20. Signature a. This Agreement may be signed in counterparts and by scan/email, each of which will

be deemed an original and both of which together will constitute one agreement.b. I, the undersigned, confirm that I have read, fully understand, accept and agree to be

bound by all terms and conditions set forth in this Agreement and that the information I have provided is true, accurate and complete.

INTEREXCHANGE

Signature ________________________________________________________________________

Print Name ______________________________________________________________________

InterExchange’s Title ______________________________________________________________

PARTICIPANT

Signature _______________________________________________________________________

Print Name ______________________________________________________________________

EXHIBIT AExtension Terms & ConditionsI agree to the following additional terms and conditions of the Agreement if an Extension is requested and granted:

1. Duration. I (and my Dependents, if applicable) understand that the duration of an Extension is the difference between the total time allotted under the U.S. Department of State Regulations for a Trainee or Intern Program minus the time already used by a Trainee or Intern (e.g., if an Intern completes a four (4) month Program, the Intern may extend a maximum duration of eight (8) months because the total time allotted under the U.S. Department of State Regulations is twelve (12) months).

2. Extension Training/Internship Plan. I understand and agree that the Extension Training/Internship Plan must describe new tasks and goals and must focus on additional skills that will be acquired during the Extension period.

3. Final Evaluations. The Host Employer and I must submit Final Evaluations from my original Training/Internship Program before InterExchange will review my Extension Application.

4. Change of Host Employer. If I change my Host Employer for the Extension period, the new Host Employer must complete a Host Employer Application and provide all the required documentation, as indicated on the Application Checklist. If my new Host Employer is not eligible to participate, I may select another new Host Employer or remain with my current Host Employer for the Extension period. However, all of these details must be finalized 30 to 60 days prior to the original Program end date as indicated on my DS-2019 Form.

5. Updated DS-2019. If my Extension Application is approved, InterExchange will issue an updated DS-2019 Form, which will cover the Extension period. I must keep the new DS-2019 along with my original DS-2019 Form, J-1 Visa and I-94 card. An approved Extension means that I am legally permitted to remain at my Training or Internship position in the United States for the duration of my status, as indicated by the dates on my new DS-2019 Form.

6. J-1 Visa. An Extension approval from InterExchange is NOT an extension of my J-1 Visa. My J-1 Visa will still expire according to the date listed on the visa. If I travel outside the USA after my visa expires, I must return to the U.S. Embassy/Consulate in my home country to apply for a new J-1 (or J-2 Visa as pertains to Dependents) that may or may not be granted. The extended DS-2019 Form does not allow my Dependents or me to enter the United States if my/our visas have expired.

7. Evaluation. If the Extension is less than six (6) months, I must complete an Extension Final Evaluation Form at the end of my program. If the Extension is more than 6 months, I must complete both an Extension Interim and Final Evaluation Form.

EXHIBIT BBackground Information Notice

1. I understand this Notice provides further communication to ensure my awareness of why and how background information is used by InterExchange.

2. I understand that any background information, including, without limitation, health information, school records and personal identifying information is gathered by me as required in my Application or separate writing to be delivered to InterExchange for the purpose of determining my suitability for the Program and the purposes described in InterExchange’s Privacy Policy and its Terms of Use.

3. I certify that I agreed to assist InterExchange by signing the Agreement and submitting the background information requested.

4. If InterExchange should require additional background information, I understand that this Notice shall remain in effect for the duration of my association with InterExchange.

5. Pursuant to the Agreement, I release InterExchange and any and all persons, independent contractors and parties with whom InterExchange maintains a contractual relationship (e.g., International Cooperators) and governmental agencies (e.g., U.S. Department of State), whether public or private, from any and all liability, claims and/or demands, by me, my heirs or others making such claims or demands on my behalf, that arise out of or pertains to the background information and/or any investigative report based on background information.

6. If I have questions about the background information and any reports derived from the background information, I agree to contact InterExchange management. I understand that I am entitled to a complete and accurate disclosure of the nature and scope of any investigation into my background upon written request to InterExchange. I agree to make requests before the completion of the Program, or not longer than 12 months after submitting background information, whichever is shorter.

CT–PA01–1212 Page 16 of 17


BACKGROUNDInterExchange is a designated Sponsor of the Career Training USA J-1 Visa Program administered by the U.S. Department of State’s Bureau of Educational and Cultural Affairs (the “Program”). The Program allows qualified Participants to enter the United States as an Intern or Trainee so that the Participant may increase their understanding of American culture and society and enhance the American Host Employer’s knowledge of foreign cultures through an open interchange of ideas.This Career Training USA Program allows Dependents to accompany qualified Trainee and Intern participants during their Program in the U.S. to enhance the Cultural Exchange exposure of Participants and Dependents. Dependents are defined under the Participant Agreement as the spouse and/or children of J-1 Visa Participants sponsored by InterExchange under the J-2 Visa. For a more extensive view of the terms used in this Agreement, the Dependent must read the Definition section incorporated into the Participant Agreement. InterExchange’s Sponsorship of a J-2 Visa is dependent upon the J-1 Visa Sponsorship (e.g., if InterExchange ends the Sponsorship of the J-1 Visa holder so that the J-1 Visa holder must return home, the Sponsorship of the J-2 Visa also ends). AgreementHaving read and understood the Participant Agreement and my role as a Dependent, I agree to the following terms and conditions of this Agreement:

1. Bound by Participant Agreement. I agree to be bound by the terms and conditions of the

Program generally applicable under the Participant Agreement. Except for terms defining the duration of the J-1 Visa holder’s Program (e.g., J-1 Visa Participant is fired or quits from the Training/Internship position) or as stated in this Agreement, I understand that the terms and conditions about the Host Employer or employment in the Participant Agreement are not applicable to me. If there is any ambiguity or issue raised concerning whether I am obligated to comply with a term of the Participant Agreement, I agree that InterExchange, at its sole discretion as Sponsor of my J-2 Visa, shall make final determination about my compliance with the Participant Agreement.

2. Effective Date. The Effective Date of this Agreement is the date upon which the J-1 Participant in the Program first submits an Application on my behalf.

3. Complete Application. I agree that I am required to complete the Application. For the purposes of this Agreement, the Application shall be considered complete upon the Participant submitting accurate and complete information about me as required by InterExchange and Program rules and Regulations and in compliance with the terms and conditions of the Participant Agreement.

4. Different or Change of Sponsorship. In compliance with the terms of the Participant Agreement, I shall not change sponsors.

5. Program. In compliance with the terms of this Agreement, I hereby agree to the following:a. I must maintain Insurance as required by the U.S. Department of State Regulations

throughout the length of my stay as a J-2 Dependent.b. I cannot come to the U.S. for any reason not arising out of or concerning my status as

a J-2 Dependent, including, without limitation, to seek medical treatment for myself or any children, or U.S. citizenship status for any unborn children.

c. I understand that I am not required to remain in the U.S., and J-1 Visa holder cannot require that I stay in the U.S. If I depart the U.S. prior to the J-1 Visa Participant, I agree to notify InterExchange regarding my departure so that my status in SEVIS can be properly amended.

6. Minor Child Dependents. I agree that the terms of the Participant Agreement shall apply to all accompanying Minor Child Dependents described in the Career Training USA Participant Application for whom I am a legal guardian (e.g., parent) in conjunction with the J-1 Participant, who must also maintain the status of legal guardian.

7. Employment. I understand that I may work as long as my income is supplemental to and not necessary for the Participant to meet the Sufficient Funds requirement under the Participant Agreement and U.S. Department of State Regulations. I understand that InterExchange does not assist nor provide services regarding submitting an application for me to work in the U.S. I understand and agree that InterExchange provides information regarding the application process “as is” and without any warranty that said information is correct. I agree that InterExchange is in no way responsible for my obtaining work. I agree that any work I pursue must comply fully with American tax and labor laws and not bring InterExchange or the U.S. Department of State into notoriety or disrepute as in generally required under the terms of this Agreement and the Participant Agreement. For more information about employment, I can investigate the subject by visiting the Career Training USA Resource Center located at the following URL:http://www.interexchange.org/career-training-usa/internship-co-op-trainee-job/resources

From the Career Resources Center, I can click on the link labeled J-2 Dependent Employment to find information offered by USCIS at its site.

8. Final Decision. I understand that InterExchange is not required to act as my Sponsor for the J-2 Visa. I agree that InterExchange, at its sole discretion, makes the final decision about my J-2 Sponsorship without regard to any decision made regarding the J-1 Participant.

9. Liability. In addition to agreeing to the terms and conditions regarding Warranties, Indemnification, Limitation of Liabilities, Release and Acts of God found in the Participant Agreement, I agree to the following terms and conditions regarding my liability under the Program:a. Assumption of Risk. I understand and agree that the main focus of the Career Training

USA Program is the Cultural Exchange of the Participant. I assume the risk regarding my participation in the Program.

b. Specific Liability. In addition to the specific liabilities included in the Participant Agreement I understand that are each applicable to me, I understand and agree:

10. Fees. In compliance the Participant Agreement and this Agreement, I agree to pay all Fees and comply with all policies regarding Fees, Cancellations, and Refunds as set forth in the Participant Agreement and the applicable Fee Schedule attached to the Participant Agreement.

11. Communication. In compliance the terms and conditions set forth in the Participant Agreement, I agree to respond to InterExchange’s communication with me during the Program.

12. Privacy and Background Information. a. Privacy.

(i) InterExchange Privacy Policy. By signing below, I agree to be bound by InterExchange’s Privacy Policy pursuant to InterExchange's Terms of Use located at www.InterExchange.org/terms-use, its Privacy Policy located at www.InterExchange.org/privacy-policy, my Application and the terms and conditions set forth in this Agreement. I agree that I read each of these documents, which (if applicable) are incorporated herein by this reference, as they form a legal agreement between InterExchange and myself regarding the Privacy Policy of the Program. I understand that in the event of any conflict between the Application, this Agreement and those of the Terms of Use and Privacy Policy, the Terms of Use and Privacy Policy shall supersede with regard to the Privacy Policy.

(ii) Participants’ duty to provide privacy. In addition to the specific requirement for Social Media listed under this Agreement, I agree to protect the privacy of any party in a relationship with InterExchange and/or Career Training USA, including, without limitation, InterExchange staff. If I have questions about my duties under this clause of the Agreement, I shall contact an authorized InterExchange manager for guidance.

b. Background Information. (iii) InterExchange. I agree that the Background Information Usage Notice is

incorporated into this Agreement in Exhibit A. The Background Information Usage Notice authorizes InterExchange to use background information (e.g., police reports and references obtained by me) for the purpose of determining my suitability for the Career Training USA Program. By signing this Agreement, I certify that I understand and agree to the purpose for which InterExchange uses the background information. By signing this Agreement, I further certify that I agree to the methods by which InterExchange procures the background information.

(iv) Host Employer. I understand and agree that the Host Employer may request additional screening of me at the Host Employer’s own expense, and that InterExchange is not responsible for any actions taken by the Host Employer. I understand that the Host Employer must conduct such investigation pursuant to the laws of the U.S. and state and local laws in which the Host Employer conduct its business.

13. Release. By signing the Agreement, I agree to the following:a. I give permission to InterExchange to (i) take and retain any photographs (including

group photos), copies of images from passports, videos, audio recordings and other depictions of me (collectively, the “Reproductions”) during activities associated with InterExchange; (ii) retain any Reproductions that I submit to InterExchange, or that I post on any InterExchange-branded or InterExchange-affiliated media site, social networking site or video upload site or “channel” or blog, including, without limitation, Facebook, Linked-In, YouTube, Twitter, or any other electronic site; and (iii) publish, distribute and display, either in whole or in part, any Reproductions in any and all media throughout the world, including, without limitation, media sites, social networking sites, video upload sites or “channels,” blogs, electronic postings, calendars, brochures, advertisements and other promotional materials.

b. I hereby waive compensation and any right to inspect or approve any such uses and Reproductions. I must not submit any Reproduction unless I first obtained permission from each person whose name, image, voice, or likeness is included in the Reproduction, and each such person has granted me and InterExchange all copyright and other intellectual property rights, including renewal rights, necessary to use the Reproduction and his or her name, image, voice and likeness in it. I hereby release, discharge and agree to hold InterExchange harmless from any liability arising out of InterExchange’s use of the Reproductions, including any blurring, distortion, alteration, optical illusion or use in composite form with other works. I hereby assign all copyright and other intellectual property rights, including renewal rights, to InterExchange, in any materials produced that are the subject of this Release.

14. Full Disclosure. I am solely responsible for the accuracy and full disclosure of any information provided by my representing agent, a legal guardian, the J-1 Participant or myself and agree to keep it completely accurate and up to date. I confirm that the information I have provided is true, complete and accurate, and upon request I will provide any additional documentation necessary to participate in this Exchange Program.

15. Signature a. This Agreement may be signed in counterparts and by scan/email, each of which will be

deemed an original and both of which together will constitute one agreement.b. I, the undersigned, confirm that I have read, fully understand, accept and agree to be

bound by all terms and conditions set forth in this Agreement and that the information I have provided is true, accurate and complete.

INTEREXCHANGE, INC. Career Training USA J-2 Dependent Visa Sponsorship AgreementThis J-2 Dependent Visa Sponsorship Agreement (‘”Agreement”) by and between InterExchange, Inc., a 501(c) (3) organization located at 161 Sixth Avenue, New York, NY 10013 (“InterExchange”), and myself, a J-2 Visa Dependent, (herein “Dependent”) defines the terms and conditions between InterExchange and myself regarding InterExchange’s Sponsorship of my J-2 Visa for the Cultural Exchange Program involving professional training of the Participant, who separately has signed and agreed to the terms and conditions of the Program under the Career Training USA J-1 Participant Agreement (“Participant Agreement”)


http://www.InterExchange.org/terms-use

http://www.InterExchange.org/privacy-policy

http://www.InterExchange.org/privacy-policy

CT–PA01–1212 Page 17 of 17


INTEREXCHANGE

Signature ________________________________________________________________________

Print Name _______________________________________________________________________

InterExchange’s Title _______________________________________________________________

J-2 PARTICIPANT

Signature ________________________________________________________________________

Print Name _______________________________________________________________________

EXHIBIT A

BACKGROUND INFORMATION NOTICE1. I understand this Notice provides further communication to ensure my awareness of why

and how background information is used by InterExchange. 2. I understand that any background information, including, without limitation, health

information, school records and personal identifying information is gathered by me as required in my Application or separate writing to be delivered to InterExchange for the purpose of determining my suitability for the Program and the purposes described in InterExchange’s Privacy Policy and its Terms of Use.

3. I certify that I agreed to assist InterExchange by signing the Agreement and submitting the background information requested.

4. If InterExchange should require additional background information, I understand that this Notice shall remain in effect for the duration of my association with InterExchange.

5. Pursuant to the Agreement, I release InterExchange and any and all persons, independent contractors and parties with whom InterExchange maintains a contractual relationship (e.g., International Cooperators) and governmental agencies (e.g., U.S. Department of State), whether public or private, from any and all liability, claims and/or demands, by me, my heirs or others making such claims or demands on my behalf, that arise out of or pertains to the background information and/or any investigative report based on background information.

6. If I have questions about the background information and any reports derived from the background information, I agree to contact InterExchange management. I understand that I am entitled to a complete and accurate disclosure of the nature and scope of any investigation into my background upon written request to InterExchange. I agree to make requests before the completion of the Program, or not longer than 12 months after submitting background information, whichever is shorter.