ICEO - WAT Home

ICEO Summer Work / Travel Program Participant Monthly Activity Report.

Participant Information

DS 2019 #:

Social Security #:

Last Name:

First Name:

Middle:

Country of Citizenship:

Date of Birth (month/day/year):

US Home Mailing Address
Address:

City:

State:

Zip Code:

Country:

Telephone:

Email:

Employer Information

Employer Name:

Employer Address:

City:

State:

Zip Code:

Name of Supervisor:

Title:

Telephone:

Fax:

Email:

Employment

1. Current employer start date (month/day/year):

Please rate the following, thus far in your program on a scale of 1-4
(1 - poor, 2 - average, 3 - good, 4 - excellent)

2. Your cooperation with your employer:

1 2 3 4

3. Your employment location:

1 2 3 4

4. Your job:

1 2 3 4

5. Approximately, how many hours per week did you work in the last 30 days?

6. Are you satisfied with your job?

yes no

7. What is your current position?

8. If you aren’t satisfied with your job, what would you change about it?

Program Services

Please rate the following on a scale of 1-4
(1 - poor, 2 - average, 3 - good, 4 - excellent)

9. Orientation Meeting (only needed for the first report):

1 2 3 4

10. ICEO’s headquarter services:

1 2 3 4

11. ICEO’s regional representative’s assistance:

1 2 3 4

12. Emergency assistance (if applicable):

1 2 3 4

13. Please list the new skills and abilities you have acquired during this portion of your program:

14. Please list the cultural activities you have taken part in during this portion of your program:

15. Comments:




	WAT Program Definition

	Social Security & Taxes

	Eligible and Ineligible Jobs

	Travel Options



	ICEO WAT:

	Jobs

	Dates and Deadlines

	Orientation

	Insurance

	Housing

	Emergency Contact

	Download Forms

	Program Extensions

	Monthly Activity Report

	Final Evaluation


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