Visiting Candidate Intake Form (Principal Investigator)

Please read through this entire form before starting (there is no save button). A Visitor should come to Stanford for a minimum of 2 months and they must stay here during the entire duration of their appointment. For more information on the Visiting line, please visit: http://med.stanford.edu/academicaffairs/faa/guidelines-instructions/appointment-promotion/visiting-titles.html Questions: manruchi@stanford. com

Basic Information

Visitor's Full Name & Email Address*

First/ Middle/ Last Email

Your Name and Email Address*

Appointment Type*

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Division*

Please select the sponsoring division

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Department Point of Contact*

Please list the name of the individual in the department we can contact for questions or additional information.

Department Sponsor*

Must be a Professoriate Faculty member

Appointment Information

Visitor Type*

Please select which appointment your candidate will be fulfilling. Please contact us if you have any questions. For a matrix on appointment titles, visit: https://stanfordmedicine.app.box.com/s/wohi3bml36qtfsdxzsdvm1e9bsq9seoi

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Intended Role: Visiting Scholar*

Unpaid. Appointed for research or scholarship only. Their visit will advance a collaborative research activity at Stanford. Recognized experts (i.e. faculty in academia, qualified personnel from industry, government, or other organizations, including retirees) who are employed or appointed at another institution or organization. Describe the nature and purpose of the visit, including the benefit to Stanford. Describe the visitor’s relevant expertise that will allow the visitor to fulfill the planned role and responsibilities. Certify that they are an expert in their field. List duties related to advancing research projects at Stanford.

Incoming Visitor Specialty

Intended Role: Visiting Faculty FTE*

Can be paid or unpaid. Use this title only if they are doing both research and teaching/mentoring. Academia: need to be on leave from home institution. Home appointment must not expire prior to the end date of the Stanford appointment. Should have same title as home institution (i.e. Assoc. Prof at home = Visiting Assoc. Prof at Stanford). List duties with FTE % break down, including teaching/mentorship and research. [Total duties should not exceed 100% FTE across all appointments. If the duties include teaching, add: teaching [name of course], including preparatory work, teaching, student guidance and grading.

Intended Role: Visiting Instructor*

Can be paid or unpaid. Coming for additional training. The training must be in an area for which there is no formal course of study, neither as an ACGME approved nor as a non-ACGME program. Not required to be employed at a home institution, but must be planning to go elsewhere after the appointment at Stanford ends. Describe the intent of this visit including what training they will receive.

Is the visitor currently in the USA with any type of Visa status?*

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Visa status*

Please provide the details of this status.

Intended Role: Visiting Postdoc*

Unpaid. Current trainee visits for the purpose of advanced studies, research or training under the guidance of a Stanford faculty sponsor. Visiting Postdocs hold an advanced training position at home institution, i.e. postdoc, medical resident, or fellow. Describe the intent of this visit including what advance studies, research, or training they will receive.

Visa Sponsorship*

Please let us know if the visitor will require a J1 visa sponsorship while at Stanford. If the candidate is not a citizen of the United States, US permanent resident (a.k.a., Green Card holder), or an EAD card (Form I-766) holder, they will need a J-1 Visa.

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PTA for DS-2019*

If a Visa Sponsorship is needed, please provide the PTA for the DS-2019 and Fedex label to ship the charge. (estimated cost: $200-$300 for Visa) (estimated cost: $20-100 for shipping).

Is the candidate for this appointment proficient in English?*

Sponsors of J Exchange Visitors must retain "evidence" of "objective measures" of a prospective Exchange Visitor’s English proficiency before a DS-2019 can be issued. As per the Department of State, a prospective visitor should have "sufficient proficiency in the English language as determined by an objective measurement of English language proficiency, successfully to participate in his or her program and to function on a day-to-day basis." Please use the form in the link below to provide proof, once completed upload the completed form along with CV field. More information can be found at: https://bechtel.stanford.edu/departments/j-1-visitors/english-language-proficiency-j-1

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English Proof Form

English Not Proficient

CV Attachments*

Must be in English and must be dated. Please use Word or PDF format only. *Proof of English Proficiency form can be uploaded here as well (required for J-1 Scholars).

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Requested Start Date*

DUE TO COVID-19, THE START DATE MAY BE DELAYED. Please see the table below for the minimum time we need to process your action. The start date should be set accordingly. We will reach out to you if the start date is not possible. A Visitor should come to Stanford for a minimum of 2 months and they must stay here during the entire duration of their appointment. 3 months – New, no visa 3 months – Reappointment, no visa 4-5 months – New/Reappt, with visa

Requested End Date*

Minimum = 2 months, Maximum = 1 year. If this is a reappointment, they may only be eligible for 1 additional year. See matrix under "visitor type" above for eligibility.

Is this a paid (salary) appointment?*

Note: Visiting Scholars and Visiting Postdocs cannot be paid.

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Salary or Hourly Rate*

Salary Methodology*

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Salary Methodology (Other)*

Explanation for "other" salary Methodology

FY Merit Eligible?*

Yes or No (No=not eligible as merit is included in proposed salary)

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Notes

Any additional information you think we should know regarding this action.

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