Academic Training Request Form

This form is to request Academic Training for J-1 students who are sponsored by Drake University. To complete the full AT request, you must complete the following steps:

- Obtain an offer of employment from intended employer

- Obtain a letter of recommendation from your academic dean/advisor

- Complete this form

- Request and attend an appointment with the International Student Advisor (please see the list of required documentation for this meeting on the website or the Blackboard ISSS Resource Hub)

Please provide responses for all fields below:

Last Name

First Name (Given)

Preferred Name (if applicable)

Drake ID

College or School (CBPA, A&S, SJMC, SOE, CPHS)

Current degree level (Bachelor's, Master's, Doctorate, etc.)

Major(s) as listed on your current DS-2019

Anticipated program end date

Complete this section. The information provided must match the offer letter from your intended employer.

Are you requesting Pre-Completion or Post-Completion AT?

Employer Name

Employer Address (include street, suite if applicable, city, state, zip code)

Job Title

Supervisor Name (First Last)

Supervisor Email

Supervisor Phone Number

Academic Training Start Date (MM/DD/YYYY)

Academic Training End Date (MM/DD/YYYY)

Salary/Income for Entire AT Period

Note any previous AT periods here (at any institution at any time)

In a few sentences, describe your AT goals and training objectives. This information can also be found on your employment offer letter and/or the letter from your academic dean/advisor.

By signing below, I certify that:

- I have read the information on the ISSS webpage about AT and have spoken to someone in ISSS about AT

- The information I have provided is, to the best of my knowledge, accurate and true

- I understand that I must pay for and be enrolled in Drake's International Student Health Insurance for the duration of my program and AT program

- I understand that I must report any changes to my address, AT program, or status within 10 days of the change.

Sign Here

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