Summer Work and Travel usa application istplus com/watusa Congratulations on applying for Summer Work and Travel! Next Steps



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Name of CIEE Representative:

Country:


Interviewed by (Name):

Representative Code:

Date (day/month/year):

WORK & TRAVEL USA

APPLICATION

A Cultural Exchange Program 

Summer 2018

8 of 9


ciee.org/in-the-usa/work/work-travel-usa

1-888-COUNCIL (268-6245)

  contact@ciee.org 

Updated:  8/8/17

FEE DISCLOSURE 

(FEES THAT WILL BE COLLECTED BY THE CIEE AGENT, CIEE OR THE U.S. GOVERNMENT)



Fee 

Amount 

Inclusions 

(Please specify currency:             )



Program fee 

Application fee



Agent 


support 

pre-departure

U.S. 


Sponsor 

support


Orientation

Insurance 



Plan

 

(for 



policy 

details 


visit 

www.ciee.org/insurance)

Screening 



for 

program


English 


eligibility 

test


Administrative 

costs



Translation 



of 

documents



SEVIS fee 

- U.S. government administrative cost



Visa 

interview 

fee 

- U.S. government administrative cost



Promotion  

Discount



Placement fee  

- All costs related to finding a placement



Expedite fee 

Expedited 



forms 

and/or 


application 

review


Housing fee 

Transportation fee 

Other services 

Total fees (excluding airfare) 

Flight (estimated cost) 

- Round-trip airfare (this is the typical cost – actual

price will depend on destination and dates selected)

Cancellation Policy:

Other program costs and pricing notes:

PARTICIPANT FEE AGREEMENT

I verify that I was provided with a copy of the CIEE Work & Travel USA application, which includes the full terms and conditions for the 

program. I confirm that I have reviewed the complete pricing information in this document and fully understood the costs of the program 

before I paid a non-refundable deposit. I understand that wages might not cover the entirety of program and living expenses and that I should 

have access to additional personal funds. 

Except as specifically modified herein, the terms of the CIEE Work & Travel USA application I previously signed remains in full force and effect.

Name Printed:

Signature: 

Date 


(DD/MM/YYYY)

:

IST Plus

IST Plus

United Kingdom

UK/IST

UK GBP (£)



Independent Job: £545

Job secured through CIEE: £620

$35 included in your application fee

$160 PAYABLE DIRECTO TO US EMBASSY AT TIME OF BOOKING INTERVIEW

N/A

Included in Programme fee if Job secured through CIEE



N/A

N/A


N/A

N/A


N/A

N/A - flights purchased independently of IST Plus and CIEE

Full cancellation policy can be found at istplus.com/watusa



Name of CIEE Representative:

Country:


Interviewed by (Name):

Representative Code:

Date (day/month/year):

WORK & TRAVEL USA

APPLICATION

A Cultural Exchange Program 

Summer 2018

9 of 9


ciee.org/in-the-usa/work/work-travel-usa

1-888-COUNCIL (268-6245)

  contact@ciee.org 

Updated:  8/8/17

INTERVIEW FORM 

(This form should be completed by a CIEE Representative based on an in-person interview.)



APPLICANT DETAILS

Last Name:

First 

Name: 


Middle 

Name:


INTERVIEW DETAILS 

Have you ever been to the U.S. before? 

  

Yes 


    

No

If yes, for what purpose?



What are the benefits to you of spending your summer living and working in the U.S.?

What cultural activities do you want to do in the United States and why?

Do you already have a job in the U.S.? 

  


Yes 

    


No

If no, what type of work do you hope to find?:

Do you have friends or relatives currently living in the U.S.? 

  


Yes 

    


No

Do you plan to travel in the U.S. during your stay? 

  

Yes 


    

No

RETURN FROM THE U.S.

What do you plan to do upon your return from the U.S.? 

  


Continue studying 

   


Other 

(Please Specify)

:

Would you consider doing an internship in the U.S. in the future?  



  

Yes 


    

No

INTERVIEWED BY

Full 

Name: 


Title:

Signature: 

Date 

(DD/MM/YYYY)



:

Additional Notes/Comments:



IST Plus

*This section will be completed by IST

Plus

IST Plus


United Kingdom

UK/IST



WORK & TRAVEL USA

JOB OFFER

A Cultural Exchange Program - Summer 2018

1 of 2


Participants visit: 

ciee.org/in-the-usa/work/work-travel-usa   Employers visit: ciee.org/partner/employers/work-travel-usa 

Participants call: 



1-888-COUNCIL   Employers 

call: 


1-866-609-CIEE

Updated:  8/3/17

EMPLOYER INFORMATION 

(ALL FIELDS REQUIRED. Worker’s compensation and business license documentation will be required by email or fax for processing.)

Company 


name:

Phone:


d/b/a 

(if applicable)

:

Fax:


Street:

TaxID/EIN:

City:

State:


Zip:

Website:


Worker’s 

Comp 


(WC) 

Provider:

WC 

Policy 


#:

We agree to provide proof of worker’s compensation insurance (or exemption from requirement) and business license as part of the vetting and 

approval process. 

  


Yes    

  


No

Note: For the business license requirement, a qualifying document is typically a certificate/permit/license issued by the state, county, or city, which authorizes you to conduct business and is 

renewed on an annual basis. For any questions regarding qualifying documents, please call our dedicated toll-free employer line at 866-351-9949.

What does your company do: 

Worksite address 

(if different from above)

 Street:

City:


State:

Zip:


Nearest major city: 

Distance to nearest major city:

Total number of international students at this location:  

Total number of all employees at this location:

Which other J-1 sponsor companies are you using to provide seasonal help?

Offer made to 

(student name)

Dates of employment 



(DD/MM/YYYY)

Maximum of four (4) months



 

From:


To:

  


We have previously employed this Exchange Visitor.  

Name of Previous Sponsor: 

Supervisor’s 

name:


Supervisor’s 

title:


Supervisor’s 

phone:


Supervisor’s 

email:


Off-season 

phone:


JOB INFORMATION

Student 


job 

title:


Is 

this 


seasonal 

position? 

  


Yes    

  


No

Please describe the seasonal nature of this position:

Job description: 

Wage per hour: 

Tips? 

  


Yes    

  


No 

Estimated weekly wage including tips: 

Average number of hours per week:  

Is an end-of-season bonus available? 

  

Yes    


  

No

If yes, please provide details: 



Overtime required? 

  


Yes 

  


No 

Overtime available? 

  

Yes   


  

No 


Overtime wage per hour: 

State minimum wage per hour 

(if greater than federal):

 

Wage pay schedule: 



  

Weekly   

  

Bi-weekly    



  

Monthly


Are meals provided during shift? 

  


Yes    

  


No 

Cost to student for meals? 

  

Yes 


  

No 


Estimated cost of meals:

Additional Wage Provisions/Deductions: Identify any training costs, equipment or uniform fees, or additional paycheck deductions.

Supplies required: Identify any uniforms, supplies, or equipment the student must supply.

What opportunities will the participant have to experience U.S. culture locally or through the workplace?



HOUSING INFORMATION

Who Provides Housing? 

  

Employer    



  

Participant 

  

International Representative (Rep initials: 



)

Housing address: 

Cost of housing per week: 

Estimated cost of utilities: 

Housing deposit:

Is housing furnished? 

  

Yes    


  

No 


How many people share a house? 

How many people share a room?

Distance from job site: 

Transportation provided: 

  

Yes    


  

No 


Cost of transportation:

Estimated commute time: 

Type of transportation:

If housing not provided, will you assist participant in finding house? 

  

Yes    


  

No 


Other housing recommendations:

Distance from job site: 

Estimated cost of housing: 

Estimated cost of transportation:

You can download this as a separate PDF to email to your US Employer 

at istplus.com/apps/watjof2018



IF YOU HAVE SECURED A JOB THROUGH CIEE VIRTUAL HIRE YOU DO NOT NEED TO 

COMPLETE OR INCLUDE THIS PAGE IN YOUR APPLICATION.


WORK & TRAVEL USA

JOB OFFER

A Cultural Exchange Program - Summer 2018

2 of 2


Participants visit: 

ciee.org/in-the-usa/work/work-travel-usa   Employers visit: ciee.org/partner/employers/work-travel-usa 

Participants call: 



1-888-COUNCIL   Employers 

call: 


1-866-609-CIEE

Updated:  8/3/17

EMPLOYER SECTION

TERMS AND CONDITIONS

The undersigned Employer agrees to the following conditions:

1. I am an authorized representative of the company named on this document with author-

ity to enter into this agreement.

2. We acknowledge the aims and objectives of the CIEE Work & Travel USA program as a 

U.S. Department of State authorized Exchange Visitor Program, with the purposes of pro-

viding cultural exchange opportunities to qualified foreign students, and advancing the 

public diplomacy goals of the United States. 

3.  We understand that the J-1 Exchange Visitor Program is intended to provide educational 

and cultural exchanges and thus agree to provide at least one cultural exchange opportu-

nity to participants at our location for each hiring season.

4.  We will adhere to all applicable regulatory provisions that govern this program, and all 

CIEE policies which relate thereto. 

5.  We warrant that the relationship between the employer and student will comply with all 

Federal, State and Local laws regarding employment and occupational health and safety.

6.  I understand that federal statutes such as Title VII of the Civil Rights Act of 1984, the 

Immigration Reform Act of 1986 and the Immigration and Nationality Act, as well as a 

large number of state statutes prohibit discrimination in the hiring of foreign nationals. 

This means that in virtually all cases, it is illegal for an employer and for a sponsor such as 

CIEE to engage in discrimination based on national origin, gender, race, religion, etc. 

7. The salary and other terms of employment meet or exceed all federal, state, and local 

minimum wage and overtime requirements and, to my knowledge, are commensurate 

with those of our U.S. employees.

8. This participant will be covered by Worker’s Compensation insurance or we are exempt 

by state law from this requirement. 

9. This participant will be an employee, not an independent contractor. 

10. I understand that participants may undertake a period of employment of no more than 

four months. 

11.  The job we are offering is the result of a one-time occurrence, a peak seasonal need, or 

an intermittent need and will not displace year-round positions for American workers.

12. I understand that hiring year-round for non-seasonal positions is  inconsistent with the 

intent of the Summer Work Travel program. I have disclosed to CIEE our seasonal hiring 

needs and the full-range of our use of J-1 programs through any sponsor.

13. I understand that we are not permitted to employ J-1 Summer Work Travel partici-

pants if we have experienced layoffs within 120 days of the participant’s employment, 

and/or if we currently have workers on lockout or on strike. We agree to notify CIEE 

immediately should these situations occur at our company prior to the end of this par-

ticipant’s employment. 

14. Neither we nor I have accepted compensation from any party in return for offering 

this job. 

15. We have fully explained the terms of employment and job details to this participant. 

16. I understand that the Department of State requires CIEE to vet all potential host employ-

ers according to the regulations of the J-1 Summer Work Travel Program.

17. We understand that this job offer is not valid until vetted and approved by CIEE, and the 

participant cannot work at my company without written approval from CIEE. I agree to 

cooperate with CIEE in this process.

18. We agree to provide proof of worker’s compensation insurance (or exemption from 

requirement) and business license as part of the vetting and approval process. 

19. If our job offer includes housing, the housing we provide will meet all applicable local laws 

and regulations, including those with respect to ventilation, utilities, and occupancy rates. 

I understand CIEE reserves the right to vet housing to be provided to participants.

20. We further attest that any wage deductions we will take to cover the cost of employee 

housing does not violate the Fair Labor Standards Act regulations set forth at 29.CFR.531. 

We further agree to obtain advance permission in writing from the student for any pay-

roll deductions or changes in deductions.

21. We understand that CIEE is responsible for maintaining contact with participants 

throughout their program.

22. I understand that I may view all fees charged to CIEE participants by visiting 

https://www.ciee.org/partner/employers/work-travel-usa/fee-disclosure

.

23. We agree to notify CIEE of participant arrivals, failure of any participant to arrive as 



expected, performance issues, significant changes to employment terms, if any partici-

pant leaves before his/her scheduled end date, any emergency involving participants, or 

any situation that impacts the welfare of participants.

24. The job we are offering is not listed as prohibited by CIEE in the link detailed below— 

https://www.ciee.org/partner/employers/work-travel-usa/regulations

.

25. We understand that the student will apply for and obtain a Social Security number 



that may not be available at the start of employment. The DS-2019 Form and I-94 card 

together will serve as proof of authorization to work.

26. We agree to comply with J-1 Summer Work Travel program regulations, as set forth 

in 22 CFR 62.32, available through the U.S. Department of State’s J-1 website 

(

http://j1visa.state.gov/sponsors/current/regulations-compliance



), or notify CIEE 

immediately of our inability to do so.

27. We will indemnify and hold CIEE harmless against any claims, liability, damages, or costs 

incurred by reason of any act, error or omission of the employer or its agents.

Name of person completing this form: 

Title:


Signature:

Date 


(DD/MM/YYYY)

:

PARTICIPANT SECTION



Name:

Atlas 


ID:

Email 


address:

Phone:


CIEE 

Representative:

Country 

of 


residence:

TERMS AND CONDITIONS

By signing below, I indicate my understanding and agreement with the following terms: 

1. This job offer is not valid until vetted and approved by CIEE. I understand that CIEE is 

responsible for vetting employment for program participants and reserves the right to 

deny any job offer according to the current and/or anticipated rules, regulations, and 

intent of the J-1 Summer Work Travel program. I understand that CIEE must provide writ-

ten approval prior to my starting to work at this company.

2. Any position offered to me is not a firm, irrevocable offer and may be revoked at any time 

before I commence employment. 

3.  In the event that the employer revokes this offer, CIEE will assist me in my effort to find 

alternative employment, but CIEE makes no guarantee that its effort will be successful. 

4.  I will be an employee-at-will, and my employment relationship may be terminated at any 

time for any reason as permitted by law by the employer.

5.  I fully understand the job offered above. I have reviewed all information related to this 

position, as provided to me by the employer, CIEE and/or CIEE Representative. 

6.  I understand that neither the employer nor CIEE can guarantee the terms of this agree-

ment and that my hours, duties, and housing are subject to change. 

7. I will report to the employer listed above within five days of my arrival in the 

United States. 

8. I will not work outside of the dates listed on my DS-2019 form. 

9. I will adhere to all CIEE and CIEE Representative rules regarding employment and pro-

gram participation, including the Terms and Conditions/Participant Declaration that 

forms part of my program application. 

10. Once I have accepted this job, I am committed to stay at this place of employment for the 

duration of the program. If I wish to change employers, I must receive permission from 

both CIEE and my CIEE Representative prior to doing so. 

11.  Should I change jobs without receiving prior permission from CIEE, or if I violate other 

CIEE rules, CIEE may terminate its sponsorship of me and I will be required to return 

home. I also understand that such termination may prevent me from receiving future U.S. 

visas.


12. I agree to adhere to all federal, state and local laws. If I do not do so CIEE may terminate 

its 


sponsorship of me and I will be required to return home. I also understand that such ter-

mination may prevent me from receiving future U.S. visas.

Signature:

Date:


Your US employer will need to sign  and date this section

You will need to sign and date this section

The following information will be completed by IST Plus


DON’T FORGET

YOUR PASSPORT

ID PAGE!

If your application is complete please send it in to us – but before you do 

please make sure you’ve completed the checklist on the 

instructions page

Please remember you won’t be able to go online and book your 

face to face interview at the US embassy until your application has 

been approved and you’ve received your DS-2019 Certificate of 

Eligibility and your SEVIS ID

Take a look at what goes into approving an application at 

https://istplus.com/j1timescales 

 

If you’ve got any questions during the process please feel free to 

contact our team via email – drop us a message via the website or send 

us an email to info@istplus.com 



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