J-1 Exchange Visitor Orientation Registration Form

Personal Information

Please complete this orientation registration form. Due to the impacts of COVID-19, all Scholar Orientations will be held virtually via Zoom. Once you complete this form, you will receive an email from ISSS to schedule your virtual Zoom orientation. Please contact ischolar@ucsc.edu with any questions.

1. Please enter your information as indicated in your passport. *This question is required.

Family Name/Surname *This question is required.

Given Name/First Name *This question is required.

Date of Birth *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

Country of Citizenship *This question is required.

2. U.S. Contact Information *This question is required.

Street Address *This question is required.

Apartment (put N/A if not applicable)

City *This question is required.

State *This question is required.

Zip *This question is required.

Email Address *This question is required. This question requires a valid email address.

U.S. Phone Number *This question is required.

3. Do you have any J-2 dependents (spouse or children) with you? *This question is required.