Download notification of arrival form

NOTIFICATION OF ARRIVAL FORM CIES is required to collect this information from scholars within 10 days of arrival. Please return to your CIES contact person immediately upon arrival. Institute of International Education Council for International Exchange of Scholars 1400 K Street NW, Suite 700 Washington, DC 20005 Telephone: (202) 686‐4000 • Fax: (202) 686‐4029 Include copies of the following documents when submitting this form to CIES: VISA AND DS‐2019 INFORMATION
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J‐1 visa stamp in your passport and in any dependent’s passport Please refer to the J‐1 visa stamp in your passport issued by the U.S. Embassy or Consulate in your country and the CIES‐issued Form DS‐2019. 
Form DS‐2019 and any dependent’s DS‐2019 8.
If entering the United States by land, you must also include a copy of: 
Form I‐94 (small white card) stapled in your passport and in any dependent’s passport Name: 2.
Country: 3.
Date of departure from home country: Date of arrival in the United States: Start date of grant activities at host institution: 6.
b. If you entered on a different program number, please indicate: 9.
Month Day Year Department City Street Address (number and street) Name of Representative Host Institution Residential address (Indicate the physical address where you are presently residing. Do not list a post office box. If your address changes, you must notify CIES within 10 days.): Month Day Year State Apartment Number City State Zip Code Telephone Number 10. E‐mail address that will be used while on Fulbright grant: Preferred E‐mail: Secondary E‐mail: 11. Preferred mailing address: 
In care of Faculty Associate 
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Residential Address Street Address (number and street) Date DEPENDENT INFORMATION 7.
Indicate below and complete Page 2, if applicable: 
No dependents have accompanied or will join me in the United States. Signature Date Dependents have accompanied or will join me in the United States. (Complete dependent arrival information on Page 2) Other (indicate below) Signature 
U.S. CONTACT INFORMATION Month Day Year Verification of grant start date (Please have a representative from your host institution verify the start date of your full‐time Fulbright grant activities.):  Faculty Associate  Other Institutional Official Other Program Number: 1.
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N ARRIVAL INFORMATION 4.
a. You should have entered the United States on a J‐1 Exchange Visitor Visa, Exchange Visitor Program Number G‐1‐00005. Indicate the 10‐digit number from top right corner of Form DS‐2019: Apartment Number City State Zip Code Telephone Number DEPARTURE INFORMATION 12. Were you issued a return ticket? 
13. Anticipated date of departure from the United States: Yes 
No Month Day Year Note: In most instances, CIES is not responsible for your return ticket and you are responsible for making return‐travel arrangements, whether it requires consultation with the airline or with the Fulbright organization in your home country. NOTIFICATION OF ARRIVAL FORM Name: Country: DEPENDENT INFORMATION (continued) The following members of my family are with me or will be joining me in the United States. Expected Date of Arrival in the Last Name, First Name: U.S. (Month Day Year) Expected Date of Departure from the U.S. (Month Day Year) Spouse Child Child Child Child Child Child Child Child Child Child J‐Visa Exchange Visitor regulations require that you provide health insurance coverage for all J‐2 dependents who are with you in the United States. This coverage must be in effect during the full period of stay while they remain in the United States, and must meet the minimum requirements set forth by the U.S. Department of State (see Part II: Section 11 of the Guide for Fulbright Visiting Scholars at http://www.cies.org/vsgrantees/). Please provide the name of the insurance carrier providing health insurance coverage for your dependents and include a copy of the policy with benefits coverage: NOTE: Failure to provide necessary health insurance coverage for all dependents in the United States may lead to grant termination. If you have not yet arranged for coverage, do so immediately. Consult the Guide for Fulbright Visiting Scholars for a list of insurance carriers offering plans that meet J‐visa requirements. If your dependents will not be arriving with you, CIES must receive confirmation of purchase no more than 30 days following the arrival of your dependent(s). I agree to comply with J visa health insurance requirements for my dependents. Signature Date