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International Students and Scholars

Required Information for Guest Speakers

Gender:

 

Birthdate: (e.g.: Use January 1, 1950. Do not use 1/1/50)

 

Citizenship:

 

Passport Number:

 

Passport Date of Expiry:

 

Country of Permanent Residence:

 

Position in Home Country:

 

Intended Visa Status: Circle one: B-1, B-2, WB, WT

 

US Social Security Number (if you have one):

 

US Individual Taxpayer Identification Number (if you do not have a US Social Security Number):

 

Dates of Activity for Which You Are Invited:

 

Brief Description of the Activity:

 

 

Total Amount of Compensation in US Dollars:

 

Mailing Address:

 

 

Work Telephone Number:

 

Work Fax Number:

 

Email address:

 

Attach a photocopy of the information page of your passport.

 

 

 

Please read the statement below and sign it if appropriate:

 

Statement of Invited Speaker: I attest that I will be engaged in the activities described above for the benefit of Lewis & Clark College for nine days or less. I further attest that I have not been paid or reimbursed by more than five other US institutions during the past six months.

 

__________________________ ___________

Signature and Date of Signing

Dear Guest Speaker,

Greetings from Lewis & Clark College in Portland, Oregon, USA.

You have been invited by a department, individual, or campus group to speak at the College. If you plan to enter the US on a tourist visa (B-1 Temporary Visitor for Business, B-2 Temporary Visitor for Pleasure, or via the Visa Waiver program), the College requires certain information to assure that you can legally receive an honorarium for your services.

According to US Department of Homeland Security guidelines, a speaker who enters the US on a "tourist visa or visa waiver" may be paid an honorarium or be reimbursed for travel expenses only if (a) the visitor is engaged in the activity for nine days or less, and (b) the visitor has not been paid or reimbursed by more than five other US institutions or organizations during the past six months.

If you meet those eligibility requirements, please print this form from the web, complete and sign it. Attach a photocopy of the information page of your passport and fax both documents to International Students and Scholars at Lewis & Clark College. The fax number is: 503-768-7301. A backup fax number is: 503-768-7320.

Full Name: (As it appears in your passport. Underline Family name)