Form A must be completed by the sponsoring department
Section 1: Intern Name and Program Information
All All dates, activities and program goals should match those described on Form DS-7002, p. 2.
1. Name: Enter name of Intern as it appears in his/her passport. Attach a copy of the passport, including amendment pages or extension stamp (if applicable).
2. Appointment Date: End date should match duration of funding available and Form DS-7002. Do not include any dates for personal use, including travel. J Interns are allowed to stay in the U.S. up to 30 days after the end date for personal reasons.
3. Position Title: Undergraduate students should be appointed as Visiting Scholars through the Office of Postdoctoral and Visiting Scholar Affairs. Exceptionally, if a graduate student is requesting to use the "Student Intern" category instead of the "Research Scholar category," please work with the Graduate Division to appoint the student as a "Visiting Graduate Student."
Section 2: Financial Support Information
The minimum monthly financial support required for J-1 non-immigrants is as follows:
Accompanying J-2 spouse: $800/month additional
Accompanying J-2 child: $400/month additional per child
*Exception: Postdoctoral appointment letter is sufficient proof to meet these requirements for title codes 3252, 3253, and 3254. No additional funding is required.
*Dependents are the Intern's spouse and children
Proof of funding is required and a full month's funding must be accounted, even if the Intern's stay is less than one full month.
All documentation must be translated to English and the amount must be converted to U.S. dollars (try the XE Currency Site for an online converter).
- UC San Diego Salary: UCSD salary will not be allowed, as the student intern category forbids displacement of US workers.
- UC San Diego-Other: Indicate non-salary support from UC San Diego (e.g., per diem, reimbursements, etc.)
- U.S. Government Agency: Only if directly paid to the Intern independently from UC San Diego's funds.
- Visitor's Home Government: Only if directly paid to Intern, such as any governmental agency, ministry or department.
- International Organization: Only if directly paid to the Intern; for example, NATO, UN, WHO
- Binational Commission: Only if directly paid to the Intern; for example, Fulbright
- Personal funds: Attach a recent bank statement in English and converted to U.S. dollars. If funds are from a family member or other individual, our office will require an additional signed statement from that individual that they will be supporting the J-1 is required.(try the XE Currency Site for an online converter).
- Other: For example, home country's employer, institute, university, private foundation, including grants not paid directly to Intern. Please specify the name and attach proof of funding.
Section 3: English Proficiency
All Interns must establish that they have sufficient English language proficiency to function in an internship environment at UCSD. English proficiency can be established in one of three ways. Please check box A, B, or C:
A. Certification by the sponsoring UCSD Intern Supervisor that an interview was conducted with the prospective Intern and the Intern's English proficiency was found to be satisfactory. The signature in Section 5 certifies this statement; OR
B. Certification by a recognized English language test. Please include a copy of the test score with this form. TOEFL test score must be 173 (computer based) or 61 (internet based); OR
C. Certification by an academic institution or English language school of the Intern's English ability. If this box is selected this section must be signed and validated by the Intern’s English instructor.
Section 4: Insurance and Site of Activity
4. Health Insurance: Indicate if the UC San Diego sponsoring department will provide for health insurance as part of employee benefits.
5. Site of Activity: If the physical internship location is not on UC San Diego Main Campus, please specify the name and full address of the location. Include all additional on- or off-campus locations, even if the sites are affiliated with UC San Diego. This information should match that of the Form DS-7002.
Section 5: Sponsoring Department Certification
The appropriate signatures are required from the department chair, faculty sponsor, and department administrator. (Affiliates may have the chief HR officer sign in place of the department chair.) This certifies that the department agrees to the terms and conditions as stated on the form. In addition, theIntern supervisor is certifying that he/she understands all of the following conditions and federal regulations:
Internship Regulations and Program Conditions:
- This internship program is not designed to recruit and train aliens for employment in the U.S.
- Sufficient planning, equipment, and trained personnel will be dedicated to provide the internship opportunity specified in the Training/Internship Placement Plan (page 2 of the DS-7002).
- The Intern has verifiable English language skills sufficient to function on a day-to-day basis (certified in Section 3.)
- The Intern is primarily in the U.S. to engage in a student internship program rather than to engage in employment or provide services to the department.
- The student internship program exposes the Intern to American techniques, methodologies, and technology and does not duplicate any of the Intern's prior experiences.
- The supervisor will not place an Intern in an unskilled or casual labor position, in a position that requires or involves child care or elder care, a position in the field of aviation, or in clinical positions or engaging in any other kinds of work that involves patient care or contact, including any work that would require student interns to provide therapy, medication or other clinical care.
- The supervisor/department will not engage or otherwise cooperate or contract with a staffing/employment agency to recruit, screen, orient, place, evaluate, or train Interns, or in any other way involve outside agencies in the program.
- The supervisor will complete and submit the required Intern Evaluation(s) in a timely manner and understands that failure to submit these evaluations could result in the termination of the Intern's immigration status. Such evaluations include a concluding evaluation, and for programs lasting more than 6 months, a mid-point, as well as a concluding evaluation. Evaluations should be submitted two weeks prior to the Intern’s departure from the U.S.
General Program Conditions:
- The supervisor will not place an Intern in a position that could bring the Exchange Visitor Program or the Department of State into notoriety or disrepute.
- The Intern has a clear understanding of what office/lab space, equipment, computer access, etc. will be available to him/her.
- The department will inform IFSO if/when the following are due to change or occur:
Form B must be completed by the prospective intern
Upon completing Form B, including p. 2, “Certification of Academic Status” and his/her portion of the Form DS-7002, the Intern should send the forms and all supporting documents directly to the sponsoring department. IFSO will not forward the forms to the department.
Sections 1: Personal Information
1. Name: Enter name as it appears on the passport, separated by Family name, Given name and Middle name.
9. Country of Legal Permanent Residence: Enter only the country from which the Intern has legal permanent residence and has the intention of residing there permanently. Do not enter the country of temporary or current residence if it is different than the country of citizenship and the Intern does not wish to abandon their home country.
Section 2: Dependent Information
J-2 status is available for legal spouse and children (under 21 years old), who are not U.S. citizens:
- Passport pages are required for all requested dependents.
- Do not request a Form DS-2019 for dependents who are already sponsored in J-2 or have their own independent statuses.
- Family members are allowed to enter the U.S. in other statuses, such as B-1/B-2 or WT/WB.
12. Dependent Travel: Indicate if J-2 dependent(s) will accompany J-1 Intern to the U.S. at the same time.
13. Separate Travel: Indicate if J-2 dependent(s) will travel separately at a later time, and if so, indicate when.
Section 3: Student Intern Certification
The Intern must sign this section (original not required). The Intern certifies that he/she understands several important conditions for the J-1 Student Internship program.
Form B, p.2, Certification of Academic Status
This form should be completed by the Intern’s Dean or Academic Advisor in the home country institution (not in the U.S.). This information is to certify that the Intern is a currently enrolled, degree-seeking student outside of the U.S. and how the proposed internship at the University of California San Diego (UCSD) is essential to Intern’s academic pursuits. The Intern should show the official a copy of the Form DS-7002: Training/Internship Placement Plan completed by the Intern’s prospective Supervisor. The official may place this form B, p. 2, in a sealed envelope to ensure privacy, if he or she chooses.
Form C must be signed by the prospective Intern
The completed Form C should be sent directly to the sponsoring department. IFSO will not forward the form to the department.
This form certifies that the Intern understands the insurance requirements.
- Indicate what type of insurance coverage the Intern will have during their stay in the U.S.
The UC San Diego Student Intern’s Form DS-7002 (TIPP) should be routed as follows:
- UC San Diego department completes all sections of Form DS-7002, excluding all signatures
- UC San Diego department sends a copy of Form DS-7002 to student intern
- Intern shows TIPP to Dean/Academic Advisor for the Academic Certification Form
- Department facilitator forwards form-fillable DS-7002, without signatures, to firstname.lastname@example.org all docs to International Faculty & Scholar Office (IFSO)(Subject line: "TIPP: [Scholar last name]" (and submits remaining DS-2019 request documentation to IFSO either as a scanned document by email to the same address or hard copy delivered to IFSO)).
Please see our annotated DS-7002 for tips on completing the form.
The U.S. Department of State requires that an evaluation by the supervisor be performed for all J-1 Student Interns prior to the completion of the internship program or, if longer than six months, at the mid-point and prior to completion of the program.
Please prepare an evaluation of the student's internship experience, to be printed on your departmental letterhead and signed by both student and supervisor, and submit to the International Faculty & Scholar Office two weeks prior to the intern's departure. The department will also need to submit the online Departure Form at this time.
Please feel free to use/modify this template for your intern evaluation:
Student Intern Name (as it appears on passport: Family, Given, Middle)
1. Describe the Intern's relations with others and his/her communication skills:
2. Please rank all appropriate Intern traits, 5 being exceptional and 1 needing substantial improvement:
Attitude toward job:
Quality of work:
3. What accomplishments and skills did the Intern achieve during the internship program?
4. What areas can the Intern improve upon?
5. Additional comments on Intern's performance, strengths, and/or skills:
Signature of Supervisor
Signature of Student Intern