Brazil Scientific Mobility Program | Current Students | Forms


Please read the instructions carefully and complete the forms as appropriate. These forms will need to be printed, signed and sent to IIE at the e-mail address indicated on the form.

You must also indicate the name of the form on the Subject Line of your e-mail.

You will also receive e-mail notifications from IIE requesting that you complete the forms listed below by the deadline stipulated by IIE.

  1. Initial Travel Itinerary Form (151 KB, PDF)—After your travel itinerary has been confirmed, you must complete this form. You should send one copy to IIE and a second copy should be sent to your Institution in the U.S.
  2. Health Insurance Confirmation Form (186 KB, PDF)—You must send this form within 10 days of your arrival in the U.S. to confirm that you are enrolled in a health plan that meets J-1 visa regulations.
  3. Student Report Initial (188 KB, PDF)—After you have registered for your first semester courses you must submit the form to IIE listing the courses you are taking for the semester.
  4. BSMP Funds Deposit Authorization Agreement Form (188 KB, PDF)—This form must be completed for stipends and reimbursements.  
  5. Blank W-9 Form (188 KB, PDF)—This form must be completed by the person/organization that would like to receive payment for program approved expenses (i.e; landlords, property management firms, universities). 
  6. Winter Break Form - Please click on the tab at the top of this page to complete the online winter break form. Before your host institution completes the fall semester, you must submit this form listing your plans for winter break.
  7. Student Report Mid-Program  (195 KB, PDF)—After completion of your first semester you must submit this form listing your grades for the previous semester and the courses that you have registered for the preceding semester.  
  8. Travel Validation Form (35 KB, PDF)—If you plan to travel outside the U.S. (including Canada and Mexico) during your Program, this form must be completed and sent to IIE for approval.
  9. Final Departure Report Form (330 KB, PDF)—All students who began their BSMP grants in Fall 2012 and did not do Academic Training during Summer 2013 should complete this form and send it to IIE 15 days before the end date of their current DS-2019 form. Send the completed form to

Please visit the "Academic Training" section of this website to access Academic Training forms.

The deadline to complete this form has passed. If you have not completed this form, please email directly.

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