USA WorkTravel项目申请表CHI

USAUSA WorkTravelWorkTravel项目申请表项目申请表CHICHI C ULTURALH OMESTAYI NTERNATIONAL104B UTTERFIELDR D S ANA NSELMO CA94960T EL 415 459 5397 F AX 415 459 2182 E MAIL CHIWT CHINET ORGCHI Agency Country Participant s Passport PERSONAL DATAL Please writein CAPITALS CHI IDCodeA tt ac hsm il in gpa ss po rt s iz ep ho toU SA WO RKattorney This willdocument proofthat youwill havea minimum USD 800in ordertobe moarily self sufficient uponarrival in the U S I the undersigned declare thatI am Parent Legal Representativeof Name ofParticipant Please PRINTname who isenrolled in CHI s USA Work Travel program I guaranteethat he she will be leavingfor the U S with aminimumUSD 800 Parents or LegalRepresentative s address Name City PostalCode CountryAddress Telephone FAX EMailSignatureof Parentor LegalRepresentative DateACKNOWLEDGEMENTOF PROGRAMRULES TERMS ANDCONDITIONSGENERAL CONDITIONSi1 The USA Work Travel Programis availableto thosewho wishto findtheir ownjob orrequest jobassistance throughCHI CHI willprovide assitancefor onejob placement 2 In aordancewith U S visa regulations the USA Work Travel participantis restrictedfrom working in thefollowing positions fields camp counselor park ranger aupair domestic helper aviation health care medical field 3 USA Work Travel participantsare requiredto havea joboffer securedprior toarriving in the U S The participantand the U S employerare requiredto submita letterof aeptancebefore the DS 2019is issued 4 The participantis solelyresponsible forsecuring andpaying foraommodations CHI willonly providehousing resourceadvice throughourprogram handbookand Interwebsite Some employersoffer housingassistance 5 The participantis requiredto pletethe basicUSA Work Travel applicationand submitproof ofactive studentenrollment as well asdocumentproof ofsufficient funds minimum ofUSD 800 in orderfor the participant tobemoarilyself sufficient uponarrival inthe U S 6 For northernhemisphere participants the programduration is from June1to October15 For southernhemisphere participants theprogram durationisfromNovember1to March15 7 The participantof the USAWork Travel Programis responsible for validationof his her visaafter arrivalto the U S The participantisrequired toreport to the sponsoragency CHI within30days from the startdate onthe DS 2019form Failure toadhere tothis policywillresult incancellation of the participant s J 1visa The participantalso understandsthat ittakes at least3days tovalidate his her visaandhe she mightnot bevalidated ontime ifhe she willsubmit allthe necessaryinformation to the sponsoringagency after25days fromthestart dateon his her DSform DEPOSIT VISA ANDINSURANCE i1 A programdeposit isrequired atthe time of application The depositis appliedtoward thebalance of the program fee 2 The entireprogramfeebalance mustbe paidin fulland the job aeptanceletter pletedBEFORE CHIcan issuethe DS 2019form 3 The DS 2019form isNOT avisa The participantmust takethe DS 2019form andapply for the J 1visa atthe nearestU S Consulate inthe participant s homecountry Without acurrent J 1visa stampedinthepassport participation inthe programin invalid 4 The J 1visa allowsthe participantto enterand legallyworkinthe U S for upto4months maximum 5 There isan optional30 day travelperiod inwhich theparticipant maytravel aroundtheU S 6 Included inthe programfee ispulsory prehensiveinsurance for the durationof theprogram asindicated ontheDS 2019form The U Sernment requiresthat allp articipantshaveinsurance coverageduring theprogram period Insurance forthe optional30day travelp throughCHI Participants arefully responsiblefor arranginginsurance to cover anyadditional timeasatourist 7 The participantagrees tobegin workno earlierthan thedate indicatedon his her DS 2019form June1or November1 AND agreestoterminate workrelations intheU S no laterthan thedate indicatedon his her DS 2019form October15or March15 8 I herebyapply forinsurance underthe CareMedInternational Travelinsurance policy insurance plannumber ace06haitz1lga issued toCareMedGmbH Bonn Germanyunderwritten byACE EuropeanGroup Ltd I understand the termsand conditionsof theinsurance planareprovided inthe CareMedInternational TravelInsurance booklet CHI W T St Appxxv1 1CANCELLATION POLICYi1 Cancellations receivedbetween thetimeofapplication submissionand issuanceoftheDS 2019form are subject toa cancellationfee Cancellations receivedafter issuanceoftheDS 2019form aresubject toa partial refund oftheprogramfee uponreceipt ofthe unusedDS 2019form Please refertotheregulations asset forthby youragency inyour homecountry 2 In caseof visadenial the unusedDS 2019form mustbe returnedto CHIwith proofof denial after whichpartialrefundwill beissued Please refertotheregulations asset forthbyyouragency inyour homecountry 3 The participantis noteligible fora refundonce he she hasentered theU S This includes changing ofjobs termination ofemploymentand or early departurefromtheU S back tothe homecountry PARTICIPANT PROGRAMEXPENSES i1 The participantis responsiblefor alltravel expenseswithin theU S This includestothe orientation siteand tothejobplacementmunity 2 CHI offershousing resourceadvice throughour website All expensesrelated tohousing anddaily livingincluding rent utilities furnishings groceries etc are theresponsibility oftheparticipant 3 The participantshould beaware thatsome jobswill haveflexible startingdates dueto weatherconditions The participantis advisedtoarrive intheU S prepared withsufficient funds USD 800minimum tocoverall expensesuntil he she beginsearning awage 4 The participantis responsiblefor any and alltravel expenses incurred afterthe workprogram andduring theoptional30 day travelperiod 5 The participant s wagewill beatleastthe minimumwage asset bytheU S Department ofLabor andis subjectof deduction ORIENTATION i1 Participation atthe CHIorientation meeting is mandatory 2 Included intheorientationmeetingisinformation aboutliving andworkingintheU S and adviceregarding applyingfortheSocialSecurity card 3 If forany reason theparticipantdoes notattend themandatory orientationmeeting he she willnot holdCHI responsiblefor anyconsequencesthat mayensue LIABILITY RELEASEAGREEMENT LInconsideration ofbeing aeptedby CHI s USAWork Travel Program I herebyrelease forever dischargeand agreeto holdharmless CulturalHomestay International its overseas Partner organizationsand or principalsthereof fromanyand all liabilityclaims ordemands forpersonal injury sickness ordeath as wellas propertydamage andexpenses ofany naturewhatsoever whichmay beincurred bythe undersignedthat mayour whileparticipatingintheUSAWork Travel Program I understand that bysigning thisRelease I fullyand pletelywaive andrelinquish allclaims Imayhave againstCultural HomestayInternational its employeesand itsoverseasPartnerorganizations thereof and releasethem fromany liabilitytheymay otherwisehave towardme whether knownto meor not I authorizeall medicalproviders torelease mypersonal medicalinformation intheevent ofan aident medical treatmentor hospitalization to CHIas myvisa sponsor I authorizeCHI touse myphotograph inits promotionalmaterialsfortheUSAWorkand Travel Program Participant s SignatureACKNOWLEDGEMENTOF PROGRAMRULES TERMS ANDCONDITIONS iDateIhave readthe rules conditions andeligibility requirementsof CHI s USAWork TravelProgramandtheParticipant Handbookand agreeto abidebythem I agreeto plywith myU S employer s rulesand policies including but notlimited topolicies such aspersonal gro