Employer Application - American Journey.

Host Employer Information

Please note, all fields are required. If not applicable, enter "NA".

Main Point of Contact

Title

Phone

Alternative Contact

Title

Phone

Company Name

Parent/Management Company Name (if applicable)

Street Address

City

State

Zip Code

FEIN Number

Worker Comp Carrier

WC Policy #

Number of FT Employees Onsite at Location

Website

Annual Revenue:

$0 to $3 Million

$3 Million to $10 Million

$10 to $25 Million

$25 Million or more

Number of (on annual basis):

J-1 Interns/Trainees

J-1 SWT

H2b

Outline how employer ensures U.S. workers are not displaced by J-1 Exchange Visitor, hereafter referred to as "Participant"

Describe the seasonal/temporary nature of employer (if applicable). Are there any periods of time the company/business is closed?

Highlight/recap the cultural exchange and/or training program that you provide. Include details on management/leadership their background, experience and credentials.

What procedures are in place to provide evaluation, feedback, and guidance? Who does the participant speak with if they have concerns or experience difficulties?

Is English the main language used when communicating to Participant and your staff?

Yes

Will the Participant train/work alongside U.S. employees daily?

Yes

How many full-time U.S. employees will the Participant train/work alongside on a daily basis in his/her program?

Is this a staffing employment agency?

Yes

Will your Intern/Trainee program involve more than 20% clerical work?

Yes

Have you laid off staff in the past 120 days?

Yes

The J-1 program is not to be a substitute or bridge program for the H-2B, H-1B or other visas. Changing the status of the J-1 visa to H-2b, H-1b or other visas is viewed by the Department of State as misuse of the J-1 visa, the Host Employer agrees not to assist Intern/Trainee to change their status.
Yes
No

Previous Experience with the J-1 Program

Have you hosted Interns/Trainees in the past three years?

Yes

Have you hosted Work and Travel Participants in the past three years?

Yes

If yes, please list the Sponsor Organizations:

Sponsor 1

Sponsor 2

Sponsor 3

Outline cultural activities organized by employer, e.g. organized sporting events, food events, celebrate American holidays, visit local museum, employee birthday events, organized volunteer events.

Outline cultural activities available in the community. Include events, sports, arts, festivals, tourist attractions. Provide as much details as possible, include months when possible.

Training/Work Information

Is pre- employment drug test required?
Yes
No

Are tests or similiar required for the Participant to complete his/her program?
Yes
No

If yes, please outline.

Please outline the position titles the Participant will train/work

Position Title	Rate of Pay

Is the employer able to guarantee a minimum of 32 hours per week?

Yes

If Participant trains/works more than 40 hours in a week, will the Participant be paid overtime?

Yes

Will the Participant ever be required to train/work more than 50 hours per week?

Yes

Can the Participant begin without Social Security Number?

Yes

Will the Participant be able to receive a paycheck before the SSN is issued?

Yes

Are there any circumstances that would delay the Participant from starting immediately upon arrival?

Yes

Please outline uniform requirements and appearance standards

Will uniform be provided by employer? If yes, describe

Identify any uniforms, safety equipment, or other supplies/requirements Participant must provide or purchase (include estimated costs)

Please describe any deductions from Participants paycheck

Will the Participant be required to pay Union Dues?

Yes

If yes, amount:

Are meals provided during shift?

Yes

If yes, cost:

Please outline benefits offered such as discounted meals, hotel room, use of facility:

For host employers in remote locations, in the event of an emergency, how do you assist the Participant with transportation? For example, if the event of evacuation or medical emergency.

Please outline how the property will assist participants during a unexpected crisis, such as Covid pandemic, hurricane etc?

Housing Information

Does employer provide housing?

Yes

If No, can the employer provide two week hotel stay and assistance in securing housing?

Yes

If yes, please describe.

If you provide housing referrals, please enter details:

What can a participant expect to pay on a monthly basis at these referrals?

Employer Provided Housing Please Complete the Following

For employers who provide housing - describe housing (apartment/dorm/house/hotel/etc.)

Housing address, complex name:

Cost of housing:

Estimated Cost or Other Utilities:

Utilities Included?
Yes
No

Is housing furnished?
Yes
No

Are there cooking facilities available?
Yes
No

Cooking Facility Details:

Is a lease or housing agreement signed?
Yes
No

How many people share a house/unit?

How many people share a room?

Distance from employer

What is the housing evacuation policy if a participant is terminated?

Are participant(s) allowed to seek his/her own housing with proper notice for reasonable cause such as dissatisfaction with living conditions,feeling unsafe, believe cost is unfair/unreasonable. Please outline policy

Transportation Information

Does employer provide transportation from airport to host site?
Yes
No

Provide arrival information including: name of airport, specific arrival dates/times, arrival policy or procedure.

Is daily transportation provided
Yes
No

Type of Transportation

Cost of Transportation

Will Participant use bicycles as transportation?
Yes
No

Additional Details to Share with Your Candidates/Participants:

AGREEMENT

By signing below you confirm that you have read and agree to all sections of the agreement.

Signature (type your name):

Title:

Date:
(Enter today's date only)

* For all intents and purposes this will be used as your legal electronic signature.

You must also sign the agreement on the next page to complete your application.

24700 Overseas Hwy
P.O. Box 420116
Summerland Key, FL 33042

866-511-0908
866-511-0908
manager@aj1.us

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