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Work Experience USA Participant 2-Week Notice Form

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Work Experience USA Participant 2-Week Notice Form
Work Experience USA Participant 2-Week Notice Form
Work Experience USA
Participant 2-Week Notice Form
For Regular Placement, Regular Job Fair Hires or Independents
(“Lock In” Participants are not eligible for 2 weeks notice)
Rev.15.07.11
To: CCUSA-Work Experience USA
My name is _________________________________________________ , my CCUSA ID number is ___________________ .
This letter is to inform you that today, _____/_____/______, I am giving my employer two weeks notice.
_____/_____/______ will be my last day of work. My rst day of work was _____/_____/______. My employer’s
company name is _____________________________________ and their phone # is ______________________________ .
I understand the following conditions if I decide to end my employment:
1. CCUSA requires that I submit this 2 Week Notice Form.
2. CCUSA requires that I must work for my employer for 2 weeks before giving 2 weeks notice, unless my employer
releases me below or CCUSA decides there are reasons to excuse me from this requirement.
3. I must discuss the entire situation with CCUSA prior to giving 2 weeks notice.
4. I agree to call the CCUSA ofce at 1-888-449-3872 during business hours (M-F 8:00am to 4:30pm PST) on my
last day of work.
5. I have ticked my chosen option (tick one only):
a. I choose to nd a new job. I must revalidate my visa in SEVIS (by visiting http://footprints.ccusa.
com), enter my new physical address and submit an Independent Job Offer within 10 days of the departure
date on this form.
b. I choose to return home. I understand that my J1 visa will be ended.
6. If I do not follow these procedures, I understand that my visa will be terminated. This results in a negative record
in the SEVIS system and requires that I leave the US immediately.
If my employer decides to waive the 2-week notice and agrees that I may leave immediately, he/she will indicate so
here.
I, this participant’s employer, agree to waive the 2-week notice for this participant, and in doing so I understand
that I must waive it for all other CCUSA staff.
I, this participant’s employer, do not waive the 2-week notice for this participant.
Employers: please tick the appropriate box above.
________________________________________ _________________________________________
Employer’s Name: Work Experience USA Participant’s Name
________________________________________ _________________________________________
Employer’s Signature Work Experience USA Participant’s Signature
Work Experience USA Participant 2-Week Notice Form