Employer Registration "*" indicates required fields 1Company Information2Point of Contact Information3Eligibility4Sites of activity5Staff Needs6Jobs Company InformationCompany Name* Company DBAif applicable Company EIN* Company address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Website Facebook Twitter Do you carry workers compensation insurance* Yes No Brief company description*HiddenArrival information for staffplease include arrival details such as nearest airport, if/when you will arrange a pick up or if they need to get a bus, etc Point of Contact InformationName* First Last Job title* Phone*Email* Skype What's App Best form of contact*telephoneemailskypewhats appother EligiblityIs your company a registered member of US Chamber of Commerce, Council of Better Business or any other business/social/charity association?* Yes No Please specify your memberships here*J1 host employers must demonstrate seasonal need. Please describe occupancy and workload of employees showing seasonal needs. Give specific numbers of permanent and temporary employees during off-season and peak season.*Cultural Exchange is the primary goal of this program. What ways do participants have to interact with U.S. citizens and experience U.S. culture in their workplace and in their time off? Please list any cultural events/historic sites/scenic areas/parks/major cities in your area.*Will hosted participants displace US workers?* Yes No Has the company experienced layoffs in the last 120 days or have workers on lock out or on strike?* Yes No Staff NeedsNumber of openings for J1 participants this season*Start of work dates* MM slash DD slash YYYY End of work dates* MM slash DD slash YYYY Number of total expected American workers*Number of total expected international workers* Housing informationIs housing provided/arranged?* Yes No Upload your housing formYou may either download and complete our housing form or attach your existing rental agreement.Max. file size: 512 MB.File UploadsWorker's CompensationMax. file size: 512 MB.Business LicenseMax. file size: 512 MB.BL expiration date MM slash DD slash YYYY Other documentsoptional Drop files here or Select files Max. file size: 512 MB. Terms and ConditionsEmployer Agreement*PROGRAM OVERVIEW: The J1 summer work travel program is an Exchange Visitor program with the intent to provide international college students a cultural exchange opportunity with employment permitted to offset living expenses and program costs. Participants with a J1 visa may only work during their university summer break and within designated program dates determined by their home country with a maximum program duration maximum of 4 months. A Participant who successfully completes his/her program may travel within the US for up to an additional 30-day grace period within the designated program dates of their home country or in time to begin the first day of university classes, whichever comes first. The Participant is only allowed to work during the dates detailed in Section 3 of an approved Form DS2019 issued by the US Department of State through the designated processor (“Sponsor”). The program regulations do not allow for any visa extensions beyond the designated program dates. The Sponsor may require completion evaluations by the Participant and the Employer. By signing this agreement, the Employer and Participant agree to abide and collaborate with designated Sponsor to remain compliant with all US, state and/or local government laws and/or regulations. J1 HOST EMPLOYER TERMS: I acknowledge that in offering this employment to a J1 international exchange visitor, I will be taking part in a public diplomacy program. I will treat the participant with respect and will promote cultural exchange opportunities. This Employment Agreement has been offered to the Participant in good faith. I hereby attest that all the information provided herein is true and accurate and I agree to fulfill the obligations as set forth herein, or as may be required by law. I understand that the participant is relying on the terms of this employment offer to cover living expenses and agree to honor this employment offer as outlined for the full term of the contract. I understand that if there is any reason or cause to modify, rescind or cancel this job offer, I must contact the sponsor immediately. Unless conduct requires, two-week notice of termination of employment is required. As an authorized officer of the Employer, I understand that I must provide the Sponsor with required vetting documentation and be approved as a host employer before this Employment Offer can be verified and approved. I understand that the participant is not legally able to begin work before this Employment Offer is approved and violation of this will result in the Participant’s termination of the program and may negatively affect the Employer’s ability to be a host employer to other Exchange Visitors. I understand, as a host employer I must inform the Sponsor immediately if the Participant does not show up by the start date or leaves before the end date as stated on an approved Forms DS2019 and if there are any issues or concerns with their employment performance, their health or general well-being. I agree to the Employer Agreement