Part 1 Confirmation & Signature
By signing below, the undersigned, representing (, Host, user, or you) and (, EV, intern, user, or you) hereby:
1. Participation and Hosting Affirm hosting of, and participation in
J-1 Internship under the Exchange Visitor Program (Program, EVP, or BridgeUSA), sponsored by FUSIA Communications, Inc. (FUSIA, Designated Sponsor, EVP Sponsor, or we), a
DOS-designated sponsor.
2. Application Acknowledge that this application consists of two parts: Part 1 – Host Eligibility () and EV Eligibility (), and Part 2 – Program Administration (). Together, these documents supplement EV’s Form DS-7002 (Training/Internship Placement Plan, ) and form part of the official program record supporting FUSIA’s responsibilities as a
DOS-designated sponsor, including oversight, compliance, and the ongoing monitoring under 22 CFR § 62.10.
3. Continuity Confirm that supervisor authorization as outlined in , along with all acknowledgments and definitions related to data privacy, access, accuracy, and validity in both and , remain in effect unless formally amended.
4. Compliance Affirm having read, understood, and agreed to all provisions of this document; clarified any uncertainties with FUSIA prior to signing; agree to comply with the terms and accept the consequences of non-compliance; acknowledge that FUSIA reserves the right to amend the terms of this document at any time, with or without prior or separate notice, and agree to cooperate with the required amendment process within the timeframe specified by FUSIA, including signing updated documents upon request; acknowledge that all provisions are binding unless explicitly marked as non-binding using terms such as “advise” or “recommend”; acknowledge that this document may contain errors, omissions, or mistakes, and waive any claim against FUSIA for any such issues made in good faith.
5. Choice of Law Acknowledge that this document, along with any related or associated materials, shall be governed by the laws of the State of New York, US. Any disputes arising from or related to participation in the Program shall be resolved exclusively in the courts of Queens County, New York.
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EV Applicant: ()
Passport # | Date:
07-05-2025 EST EST
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Supervisor(s): | Host: ()
EIN | Date:
07-05-2025 EST EST