Exchange Visitor Mentor Agreement

Cal Poly International Center logo

To be completed by exchange visitor’s mentor/supervisor at Cal Poly

Please read the following requirements of the exchange visitors mentor/supervisor and sign below. 

    • I will evaluate the Visitor’s English language skills to determine that the visitor has sufficient proficiency in the English language to successfully participate in his or her program and to function on a day-to-day basis."
    • Use one of the following "objective measurements of English language proficiency" to determine an applicant's language proficiency: 1) A recognized English language test; 2) Signed documentation from an academic institution or English language school; or 3) A documented interview conducted by the sponsor either in-person or by videoconferencing, or by telephone if videoconferencing is not a viable option
    • I will supply to the International Center evidence of how they measured applicants’ English language proficiency so that it may be made available to the Department upon request. 
    • I will assist the visitor in arranging for housing, bank accounts, ID cards, and other logistics for living in the area and working at Cal Poly.
    • I understand that the law requires J-1 exchange visitors and their dependents in the U.S. to hold health and accident insurance.
    • I understand that if the exchange visitor does not have insurance and does not purchase insurance effective immediately upon arrival in the USA, the exchange visitor will be terminated immediately from this J-1 program and that the Cal Poly International Center will notify the Department of State of the termination.  
    • I will make sure the exchange visitor checks-in with the International Center as soon as possible after arrival in the U.S.  The exchange visitor must report to the International Center within 10 days of arrival in the U.S.  I am responsible for ensuring that the exchange visitor reports to the International Center, and the exchange visitor’s failure to report to the International Center may result in termination of the exchange visitor’s program at Cal Poly.  
    • I will notify the International Center if the exchange visitor will not be participating in this program or terminates his/her program participation before the scheduled end of program. 
    • I will notify the International Center if the exchange visitor needs to exit the USA at any time during the program.
    • I realize the visitor is solely responsible for any implications resulting from failure to maintain J-1 visa status.
    • If there are any questions, I will refer the visitor to the International Center for clarification as soon as possible.
  • By typing my name below, I verify that I agree to the terms above.  I type my name as if signing on paper.

Related Content