Academic & Immigration Review Application

Exchange Visiting Scholar Program: Academic & Immigration Review Application

UA Little Rock Departmental Information

Host Faculty Name(Required)

Host Faculty Department(Required)

Host Faculty Email Address(Required)

Enter Email Confirm Email

Who will be the UA Little Rock point of contact for the application process?(Required)

The hosting faculty member

Another UA Little Rock faculty/staff member

Point of Contact's Name(Required)

Point of Contact's Email Address:(Required)

Enter Email Confirm Email

Host Department Chair:(Required)

Chair's Department(Required)

Chair's Email Address:(Required)

Enter Email Confirm Email

Dean of Hosting Department:(Required)

Dean's College(Required)

Dean's Email Address:(Required)

Enter Email Confirm Email

Visiting Scholar's Personal Information

Family Name/Last Name:(Required)

First Name:(Required)

Other Names Used:(Required)

Date of Birth(Required)

Current Email Address:(Required)

Current Mailing Address:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If your country does not utilize ZIP / Postal Codes, enter '00000' in order to complete the form.

Address on U.S. Driver's License, if they have one:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Current Phone Number(s):(Required)

Gender:(Required)

Male

Female

Marital Status:(Required)

Married

Unmarried

Visiting Scholar's Citizenship Information

City of Birth:(Required)

Country of Birth:(Required)

Country of Permanent Residence:(Required)

Country of Citizenship:(Required)

Does the visiting scholar have a dual citizenship?(Required)

Yes

If yes, please explain.(Required)

Visiting Scholar's Accompanying Dependent(s)

Will any immediate family members be joining the visiting scholar?(Required)

Not at this time.

A spouse will be joining the visiting scholar.

One or more unmarried children under the age of 21 will be joining the visiting scholar.

Dependent Disclaimer(Required)

Please note that, according to U.S. immigration laws and the Exchange Visitor Program, only one spouse may accompany the visiting scholar as a dependent. Additionally, only unmarried children under the age of 21 may accompany the visiting scholar as dependents. For every dependent that accompanies the visiting scholar, the required health insurance will increase in price.

I understand and will communicate this information to the visiting scholar.

Dependents' Passport ID Pages(Required)

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 1 MB.

Visiting Scholar's Professional Information

Academic Field:(Required)

Current Occupation:(Required)

Employer/Institution in Country of Permanent Residence:(Required)

Visiting Scholar's CV or Resume(Required)

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 1 MB.

Copy of Passport ID Pages(Required)

Please attach a copy of the visiting scholar's passport ID page, as well as a copy of the passport ID pages for all accompanying dependents.

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 1 MB.

J Visa Program Information

When will the visiting scholar's J program begin?(Required)

Note: This section is NOT asking for the visiting scholar's travel dates, but for their proposed dates of research at UA Little Rock. Visiting scholars can enter the U.S. 30 days before and stay 30 days after J program dates.

When will the visiting scholar's J program end?(Required)

See note on the previous question for important details.

Which J category will the visiting scholar be?(Required)

Research Scholar

Professor

Short Term Scholar

Student Intern

There are three main categories for J visas. 1. Research scholar: the visiting scholar’'s primary activity will be research. The maximum time allowed in the U.S. on this visa is five years. 2. Professor: the visiting scholar's primary research activity will be teaching. The maximum time allowed in the U.S. on this visa is five years. 3. Short Term Scholar: The visiting scholar's primary activity will be lecturing, consulting, or attending seminar/conference/study tours. The maximum time allowed in the U.S. on this visa is six months. No extensions are allowed. 4. Student Intern: The visiting scholar is a student in another country who will be doing research at UA Little Rock as part of his/her degree requirements. The maximum amount of time allowed in the U.S. on this visa is 12 months.

Has the visiting scholar obtained a U.S. Visa?(Required)

Yes

If yes, what type?(Required)

Has the visiting scholar visited the United States in the past two years?(Required)

Yes

If yes, what best describes his/her visit?

Vacation

Research

Attended School

Academic Appointment

Business

Verification of Past U.S. Visits(Required)

I will have a conversation with the visiting scholar about the purpose, dates, and visa type for their previous visit to the U.S. if they have visited the U.S. before.

I agree.

Has the visiting scholar ever been a citizen or legal resident of a country besides their native country?(Required)

Yes

Is the visiting scholar's passport or permanent residency document currently invalid?(Required)

Yes

If yes, provide details:(Required)

What are the visiting scholar's plans after returning to his/her native country?(Required)

Has the visiting scholar applied for U.S. citizenship or permanent U.S. residency:(Required)

Yes

If yes, provide details:(Required)

Does the visiting scholar have any previous or current foreign military service?(Required)

Yes

Has the visiting scholar been involved in any past or current foreign talents programs?(Required)

Yes

If yes, please explain:(Required)

English Language Proficiency Verification

I have determined that the visiting scholar has sufficient English proficiency to participate in this program.(Required)

Yes

How have you verified the visiting scholar’s English language proficiency?(Required)

TOEFL or IELTS scores

The visiting scholar has attended a U.S. school for at least two years

Interview with at least two UA Little Rock faculty members

See the English Language Proficiency Assessment Form.

Financial Support Information and Documentation

Note: the following document(s) must be in English. Please verify this before submitting. All documents must be dated within the last six months.

How will the visiting scholar be supporting him/herself and any dependents?(Required)

UA Little Rock funding (see below)

Funding from the visiting scholar's government

Visiting scholar's personal funds

Fulbright Scholarship

Other organization(s)

Does the department receive funding for international exchange from one or more U.S. Government Agency(ies) that will be used to support this exchange visitor?(Required)

Yes

Indicate all U.S. Government Agencies that will be providing international exchange funding for the scholar:(Required)

If other, please provide a funding agency.

I have verified the visiting scholar’s funding information, and it meets UA Little Rock's minimum monthly amount required.(Required)

I agree.

Financial Support Documentation(Required)

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 1 MB.

Health Insurance Verification

Will the visiting scholar be enrolling in UA Little Rock health insurance?(Required)

Yes

No, the visiting scholar will be enrolling in private coverage.

The visiting scholar will decide at orientation.

Statement of Compliance with Exchange Visitor Health Insurance Requirements (Submit Statement of Compliance with Exchange Visitor Health Insurance Requirements Form)(Required)

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 1 MB.

Scope of Work Information

Dates of Proposed Activity.

From(Required)

To(Required)

How many hours per week will the visiting scholar work or volunteer on the proposed activity?(Required)

Location (building and room) where visiting scholar will conduct research:(Required)

Does the proposed work to be done, equipment to be used, and research materials used meet the definition of Fundamental Research Exclusion and are not export controlled?(Required)

Yes

Provide a detailed description of the activities/scope of work in which the visiting scholar or volunteer will engage for the duration of the program or for the host faculty member. Include any projects that the visiting scholar will be working on.(Required)

To comply with federal export control requirements, what specialized laboratory equipment, materials, instruments, software, or machinery will the visiting scholar use while at UA Little Rock while working on your projects? (Please list)(Required)

Is the proposed activity associated with an externally funded program?(Required)

Yes

If yes:

a. Source of external funding, title of funded program, award number, and date of award: b. Description of the funded program:

What are the expected outcomes of the visit?(Required)

Will the visiting scholar be involved in any export control issues?(Required)

Yes

If yes, please explain.

Explain how the hosting faculty member will monitor the progress and welfare of the visitor to ensure that the visiting scholar obtains sufficient guidance to fulfill the objectives of the program.(Required)

Hosting Faculty Member Attestations

The hosting UA Little Rock faculty member must complete the following section. These attestations are required and are considered binding by UA Little Rock.

I have completed the CITI Training on Export Control and the Responsible Conduct of Research CITI training.(Required)

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Accepted file types: jpg, gif, png, pdf, Max. file size: 1 MB.

I have a working knowledge of federal, state, and university policies that govern the terms of a visiting scholar.(Required)

Yes

I will ensure that the visiting scholar completes Export Control and the Responsible Conduct of Research CITI training prior to engaging in UA Little Rock research.(Required)

Yes

Please send their certificates to the Export Control Officer at exportcontrol@groups.ualr.edu upon completion.

I will ensure there is no conflict of interest in collaborating with the visiting scholar.(Required)

Yes

I have informed the visiting scholar in writing that UA Little Rock faculty have first rights of publication of any discovery, data, or other research‐related findings.(Required)

Yes

I have informed the visiting scholar that UA Little Rock is not obligated to provide compensation or extensions to visits beyond the terms of the agreement.(Required)

Yes

I understand that the department will not agree to pay any fees without the express written approval of the sponsoring dean.(Required)

I understand.

No fees will be charged by the hosting faculty or department to the scholar.(Required)

I agree.

I have determined that the visitor has the appropriate education and experience to perform and participate in the proposed activity.(Required)

Yes

I will ensure that the availability of office space, non-export controlled equipment, materials and/or supplies, and other necessary support will be available to the scholar for the duration of his/her program at UA Little Rock.(Required)

I agree.

I will be physically present for the duration of the scholar’s activity at UA Little Rock except for short reasonable absences of time during which my on campus designee will be responsible.(Required)

Yes

I will monitor the visitor’s progress to ensure successful completion for the program objective.(Required)

Yes

I understand that as the sponsor of the visiting scholar, I am responsible for that individual’s conduct while on campus.(Required)

I understand.

The visiting scholar has been provided a copy of standard operating procedures for UA Little Rock laboratories and a copy of UA Little Rock policies.(Required)

Yes

Not yet, but they will.

I certify that I understand all hiring rules of UA Little Rock and will comply fully with them.(Required)

Yes

I certify that the information provided on this application is true and accurate.(Required)

Yes

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About

Foreign Travel Process

Exchange Visiting Scholars Program

Related Areas

Exchange Visiting Scholar Program: Academic & Immigration Review Application

UA Little Rock Departmental Information

Visiting Scholar's Personal Information

Visiting Scholar's Citizenship Information

Visiting Scholar's Accompanying Dependent(s)

Visiting Scholar's Professional Information

J Visa Program Information

English Language Proficiency Verification

Financial Support Information and Documentation

Health Insurance Verification

Scope of Work Information

Hosting Faculty Member Attestations

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