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Please fill out this form for most efficient service.

I am a/an:

This form is used for new participants only! If you are a current AmerEx program participant, you must log into your account in our online system AXIS and communicate your questions through the Comments section. If this is a serious emergency that requires our attention, please use the emergency toll free number that has been provided to you.

Name (Last, First):
City & State:
Email:
Telephone Number:
Interest (please check all that apply):	Work & Travel Internship / Trainee H-2B
When are you interested in participating? (mm/yyyy to mm/yyyy):
Have you ever participated in the J Visa program?:	Yes No
Are you currently in the United States?:	Yes No
Have you ever participated in any exchange programs to the U.S.?:	Yes No
Please provide detailed explanation of your interest, whether you are already working with an agent in your home country and other reasons for your inquiry so that we can respond to you in the best way:

American Exchange Organization
6820 Commercial Drive, Suite D,
Springfield, VA 22151
Main Office: +1 703 226 2400
Toll Free: +1 888 565 5650
Fax: +1 703 813 1788
Skype: amerex_usa