AYP High School Enrollment HSE

Enrollment Form

for a J-1 Student in a U.S. High School
Dear School Official,

A family in your school's zone would like to host a United Studies exchange student. It is our hope that you will enroll this student as a means of globalizing your classrooms and fostering intercultural understanding.

Both the family and student have been carefully screened by United Studies to ensure a successful exchange, and United Studies will maintain regular contact with them and support them throughout the exchange. We will also be in touch with you and be available to assist you at any time.

United Studies' high school academic year program for "J-1 visa" students is designated and overseen by the U.S. Department of State Office of Designation's Private Sector Programs Division (844-300-1824) and listed by the Council on Standards for International Educational Travel (CSIET).

To indicate your agreement to enroll the student, please complete the form below.

United Studies Staff

ayp@unitedstudies.org - www.unitedstudies.org - 501-321-2000
Exchange Student*

First NameLast Name
Country*
Type of Program*

Academic YearFall SemesterSpring SemesterCalendar Year
School Name*
School Address*
School Phone*
1st Day of School Year*

MonthDayYear
1st Day of 2nd Semester (Projected)*

MonthDayYear
Last Day of School (Projected)*

MonthDayYear
Local Coordinator*

First NameLast Name
Local Coordinator Phone*
Local Coordinator Email*
example@example.com
Host Family*
Host Family Address*
Host Family Phone*
Host Family Email*
example@example.com
Government Agency that Oversees J-1 Exchange Programs:

U.S. Department of State Office of Designation, Private Sector Programs Div., 844-300-1824
As the principal or other official designated with the authority to approve enrollment of exchange students at this school, I certify that:
- this school is accredited by the appropriate accrediting agency;
- I have received and reviewed the student's biographical, medical, and academic records and approve enrollment of the student for the time period stated above;
- and tuition for this student will be waived, whereas the fee(s) detailed below will be the responsibility of the student.
Fee(s) (e.g. "Book fee $__. Activities fee $__." or "No fees."):*
Signature of School Principal or Other Official*

Clear
Name of School Principal or Other Official*

First NameLast Name
Job Title*
Email*
example@example.com
Date*

MonthDayYear
Date
Should be Empty:

Enrollment Form