Please complete your check in here. 2017/2018 Check Ins 2017 Winter/2018 Summer Check Ins Name* First Last Date of Birth* Telephone to reach you in the US*Email* SEVIS ID (begins with N00) found on your DS2019 Form*Current Living Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Current Employer*Current Employer Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Manager's Name*The person at your work locationManager's Contact Phone*Are you currently satisfied with your current employment?*YesNoPlease explain your concerns with your current employment Are you financially able to sustain yourself?*YesNoPlease explain your financial status Please confirm your expected departure date* Cultural Exchange Log* Please provide a detailed outline of the cultural exchange activities you have enjoyed to date. Examples may include but are not limited to attending local events such as concerts, race, fair, among others or visiting national parks, beaches, shopping, etc.Please use this space to communicate any concerns you may have. We LOVE viewing photos!Please use this space to upload photos of your housing, employment or cultural exchange. You at your best!I have read and understand the J1 Participant Orientation and SWT Participant Letter*I confirm