Forms for Grantees Studying in the United States

Forms you must complete before your departure:

• Agreement Between LASPAU and Grantees who are Married and/or Have Children: Sent to you by mail as soon as you have been awarded a grant, this form explains the requirements for bringing your family to the United States. Your signature demonstrates to LASPAU that you understand and accept these requirements.

• Dependent Visa Information Form: This form allows LASPAU to initiate the processing of J-2 family visas. It outlines required information and should be completed and sent to LASPAU with all required documentation three months before your family's planned arrival. Click here to access a PDF version of this form.

Forms you must complete after your arrival:

• Confirmation of LASPAU Grantee Presence at Host Institution: Have your international student advisor or the appropriate official sign this form indicating your date of arrival at the university, and return the completed form to LASPAU within 15 days of your arrival. We need this form in order to maintain your legal status in the United States and issue you further maintenance payments. Click here to access a PDF version of this form.
  
• Information Sheet: This sheet includes three forms: 1) the Grantee Information Form provides LASPAU with information about you, your university, and your home institution; 2) the Program Planning Form provides confirmation that your academic program meets the requirements of your LASPAU-administered grant; 3) the Academic Information Release Form authorizes LASPAU to obtain your academic information from your university in the event of your absence. Complete and return the Information Sheet to LASPAU within 30 days of starting your academic program. Click here to access a PDF version of this sheet.
  

Forms you must complete during your program:

• Academic Progress Report: Twice a year, you will be asked to report electronically on your grades and enrollment plans. The electronic report will, in turn, be sent to your program sponsor. You will be notified when this form is available on the LASPAU website.
  

• Summer Planning Form: Complete and return this form to LASPAU by mid-April to avoid problems with tuition coverage or delays in maintenance payments. Click here to access a PDF version of this form.
  

Forms you must complete at the end of your program:

• Confirmation of Program Completion Survey: In this form, you are asked to evaluate your program and provide information about your academic institution and department. Click here to fill this form out online.
  

• HTH U.S. Plan Summation: If are studying in the United States and plan to use HTH Worldwide as your health insurance provider, download a copy of the HTH Plan Summation (PDF). If you have any questions regarding your insurance provider, please contact your LASPAU advisor.
  
  
• HTH U.S. Claim Form: If you are studying in the United States and are currently covered by HTH health insurance and need to be reimbursed for medical expenses, you can download a HTH claim form (PDF) here. Please be sure to read the HTH Frequently Asked Questions before filling out a claim form. Forms must be mailed to HTH Worldwide Insurance Services, Claims Department, PO Box 39, Minneapolis, MN 55440-0039. Do not mail forms to LASPAU.

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