EMF Work/Travel Check-In Form

Instructions

You must check-in to activate your health insurance and activate your record in SEVIS.  Failure to check-in will result in loss of your health insurance, cancellation in SEVIS, cancellation of your program, and your immediate return home. 

You may check-in one of two ways:

  1. Fill out the form below
  2. Fax the check-in form provided with your DS-2019 packet to 972-496-1361

If you have any questions or concerns about the check-in process, please call us at 1-800-HOST-EMF. If you reach voice-mail when you call, please leave a message that includes your name, a phone number where we can reach you, and the best time to call. 

 

EMF Work/Travel Check-In Form

Personal Information

First Name:     Last Name:

Birth Date:  

The Date You Arrived in the U.S.:

Your E-mail Address:
(Please enter the e-mail address that you will be using while you are in the US)

US Living Address

Street Address:

City:      State:      ZIP Code: 

Telephone: Area Code (3-digits) - Prefix (3-digits) - Number (4-digits)

Employer Information

Company Name: 

Manager/Supervisor: 

Street Address: 

City:      State:      ZIP Code: 

Telephone: Area Code (3-digits) - Prefix (3-digits) - Number (4-digits)

Entrance Information

DS-2019 Number:  N  (This number is located in the top right corner of your DS-2019)

I-94 Admission Number: (The I-94 is the white form you filled-out on the airplane)

Please check all the information you have entered before clicking on the "Submit" button below.