Exchange Visitor Visa Sponsorship Waiver Form
Please complete this form to request a waiver of sponsorship for your exchange visitor program. All information provided will be used solely for processing your waiver request.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Organization / Sponsor Name
*
Exchange Visitor Program or Department
*
Program Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Program End Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Sponsorship Waiver Request
*
Waiver Acknowledgment and Request
*
Signature / Confirmation
*
Submit Waiver Request
Submit Waiver Request
Should be Empty: