J-1 Exchange Visitor Visa Program

J-2 Dependant Application Form

Instructions: / Dependants eligible for J-2 Dependant status are unwed children under the age of 21 years old and your spouse. J-2 dependants will be issued a separate DS-2019 certificate and required to attend a Consulate appointment to receive a J-2 visa. This form only entitles the dependant to travel with the J-1 participant, but does not allow them to work in the US. As a J-1 visa holder it is your responsibility to prove dependants have appropriate health insurance and adequate financial support for each J-2 dependant in the amount of $1,500 per month per J-2. Please be aware that insufficient financial support for J-2 dependants could result in visa denial at the Consulate. The J-2 Dependant application fee is $300.
Requirements / The GACC requires the following information:
(Please make sure to place the documents in the order listed below for each dependant.) / J-2 Dependant Application Form.
Proof of dependant status: marriage certificate for spouse and/or birth certificate for child.
Proof of financial support for each dependant. Please show bank stamped statement of support.
Proof of insurance coverage: policy summary, dates of coverage and policy cover letter or verification.
Copy of valid passport.
J-2 Dependant
Information
Last Name (family name)
First Name / Other Name(s) (as listed on passport)
Gender: Male Female
Date of Birth (month/day/year)
City of Birth / Country of Birth / Country of Citizenship
Country of Permanent Legal Residence / Passport Number / Passport Expiration Date (mm/dd/yyyy)
Relationship to J-1 Participant
Health Insurance Information / Insurance must meet the following requirements:
  • Accident insurance coverage up to $100,000 per sickness or accident;
  • Repatriation expenses up to $30,000 for remains;
  • Coverage for medical evacuation to trainee’s home country in the amount of $10,000.
This insurance must cover the entire duration of the dependant’s stay including the 30 day grace period. Insurance policies must be submitted for GACC’s review prior to the issuance of the J-2 dependant visa.
Please Certify: / I have secured the appropriate insurance for my dependant. I have attached a copy of the policy summary, dates of coverage and policy cover letter or verification
I understand that there are risks associated with living abroad and do not hold the GACC liable for any illness or injury that my dependant incurs while participating in the program.
J-1 Participant Confirmation / I, / certify that the information provided on the J-2 dependant listed above is true and
Full Name / complete to the best of my knowledge.
Signature / Date (mm/dd/yyyy)

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