U.S. Department of State *OMB APPROVAL NO.

1405-0170
EXPIRATION DATE: 08-31-2012
TRAINING/INTERNSHIP PLACEMENT PLAN ESTIMATED BURDEN: 2 hours

PARTICIPANT INFORMATION
Trainee/Intern Name (Last, First, MI) Email Address

Check one: Current Field of Study or Profession If Professional, Number of Years Experience in Field
✔ Trainee
Intern
Type of Degree or Certificate Date Awarded (mm-dd-yyyy) or Expected Training/Internship Dates (mm-dd-yyyy)
Student Intern From To

SITE OF ACTIVITY INFORMATION

Name of Supervisor (Last, First, MI) Title

Email Address Telephone Number

Host Organization Name

Street Address of Training/Internship Site Suite City State ZIP Code

Website DUNS Number Employee Identification Number (EIN)

Hours Per Week Will Trainee/Intern receive a stipend? If yes, how much?
Yes No $ per

CONTRACT AGREEMENT
I understand that false certification may subject me to criminal prosecution under 18 U.S.C. 1001, which reads: "Except as otherwise provided in this
section, whoever, in any matter within the jurisdiction of the executive, legislative, or judicial branch of the Government of the United States, knowingly
and willfully falsifies, conceals, or covers up by any trick, scheme, or device a material fact; makes any materially false, fictitious, or fraudulent
statement or representation; or makes or uses any false writing or document knowing the same to contain any materially false, fictitious, or fraudulent
statement or entry; shall be fined under this title or imprisoned not more than 5 years, or both."

NOTE- Sponsors will not enter into any contracts, issue Forms DS-2019, or allow a Trainee/Intern to begin a training/internship program until all three
parties have executed this Training/Internship Placement Plan and proof of the insurance required under 22 CFR 62.14 is on file with the sponsor.
Trainee/Intern- I hereby acknowledge that I have reviewed, understand, and will follow this Training/Internship Placement Plan.
Trainee/Intern Signature Date (mm-dd-yyyy)

Supervisor- I certify the following:

1. I have reviewed and approved and will follow this Training/Internship Placement Plan;
2. I will adhere to all applicable regulatory provisions that govern this program (22 CFR Part 62);
3. I will conduct the required periodic evaluations of trainees/interns; and
4. I will notify a designated sponsor contact (1) regarding any concerns about, changes in, or deviations from the Training/Internship Placement Plan;
and (2) in the event of an emergency involving a trainee/intern.
Supervisor Signature Date (mm-dd-yyyy)

Sponsor - I certify as the sponsor that the attached Training/Internship Plan is approved and that:
1. Sufficient resources, plant, equipment, and trained personnel will be available to provide the specified training/internship program;
2. Continuous on-site supervision and mentoring of trainees/interns will be provided by experienced and knowledgeable staff;
3. Trainees/interns will obtain skills, knowledge, and competencies through structured and guided activities such as classroom training, seminars,
rotation through several departments, on-the-job training, attendance at conferences, and similar learning experiences, as appropriate in specific
circumstances;
4. Trainee/interns will not displace full- or part-time or temporary or permanent American workers or serve to fill a labor need, and the positions that
trainees/interns fill exist solely to assist them in achieving the objectives of their participation in training/internship programs; and
5. Training/internship programs in the field of agriculture meet all the requirements of the Fair Labor Standards Act, as amended (29 U.S.C. 201 et
seq.) and the Migrant and Seasonal Agricultural Worker Protection Act, as amended (29 U.S.C. 1801 et seq.).
Sponsor Signature Date (mm-dd-yyyy)

Program Sponsor Name Program Number

Intrax Career Training P-4-10008
DS-7002
08-2009
Program Sponsor Name Program Number
Intrax Career Training P-4-10008
TRAINING/INTERNSHIP PLACEMENT PLAN
Each Training/Internship Placement Plan should cover a definite period of time and should consist of definite phases of training or tasks performed
with a specific objective for each phase. The plan must also contain information on how the trainees/interns will accomplish those objectives (i.e.
classes, individual instruction, shadowing, etc.). Each phase must build upon the previous phase to show a progression in the training/internship. A
separate copy of page 2 must be completed for each phase if applicable (i.e.; if the trainee/intern is rotating through different departments).

Name of Trainee/Intern (Last, First, MI) Field of Training/Internship

Name of Phase Start Date for this Phase End Date for this Phase
Orientation Phase 1 of 5
(mm-dd-yyyy) (mm-dd-yyyy)
Brief Description of Trainee/Intern's Role for this Program or for this Phase

The trainee will receive training in Hospitality and Tourism with an emphasis in Restaurant Management. The trainee will gain
experience and develop management skills by being exposed to day-to-day operation as well as shadowing the management team.

Specific Tasks and Activities to be Completed for this Program or for this Phase (Interns) or Methodology of Training and Chronology/Syllabus for this
Phase (Trainees)

- Complete safety and food standards training.

- Introductory training in the departments: use of equipment, day to day operations, and personnel.
- Overview of each department: function, structure, business operations, and services.
- Assist with basic projects and activities designed to develop the trainee's familiarity to daily operations in one department.
- Trainee1 will have opportunity to get acclimated to the surroundings and new culture.

Specific Goals and Objectives for this Program or for this Phase

The trainee’s first month at the restaurant will be dedicated to providing an Orientation that introduces him/her to the restaurant’s
policies, procedures, operations, and customer service standards. S/he will be introduced to the daily activities of the business, as well
as the staff.

Knowledge, Skills, or Techniques to be Imparted During this Program or During this Phase

The trainee will receive a cross training, introducing him/her to the various departments. Trainee1 may spend more time in one
department during the first month and learn how each specific department relates and coordinates with all other departments.

Methods of Performance Evaluation and Methods or Supervision for this Program or for this Phase

The training advisor will provide day to day supervision and feedback for the trainee. It is the responsibility of the advisor to ensure the
trainee's questions and concerns are addressed. Reviews will be held at the end of each phase to ensure the trainee is prepared to
continue in the program. A final evaluation at the end of the final phase will measure the trainee's overall development and learning.

PRIVACY ACT STATEMENT

AUTHORITIES: The information is sought pursuant to Section 102 of the Mutual Educational and Cultural Exchange Act of 1961, as amended (the
Fulbright-Hays Act)(22 U.S.C. 2452) which provides for the administration of the Exchange Visitor Program (J visa).
PURPOSE: The information solicited on this form is necessary to provide clarity of training and intern programs offered to foreign nationals by United
States entities designated by the Department of State to conduct exchange visitor programs, for general statistical use within the Department of State,
and to enable the Department of State to effectively administer the trainee and intern categories of the Exchange Visitor Program. Failure to provide
the information requested on this form may result in non-participation in the Exchange Visitor Program.
ROUTINE USES: The information on this form may be used in reviewing complaints, in formulating statistical data on training and internships
programs conducted under the Exchange Visitor Program, and may be shared with overseas counterpart offices of the Department of State to ensure
proper administration of this Program for exchange purposes. The information provided may also be released to federal, state, local, or foreign
government entities for law enforcement purposes.
Public reporting burden for this collection of information is estimated to average 2 hours per response, including time required for searching existing
data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection. You do
not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy of this
burden estimate and/or recommendations for reducing it, please send them to: A/GIS/DIR, Room 2400 SA-22, U.S. Department of State, Washington,
DC 20522-2202

DS-7002
Program Sponsor Name Program Number
Intrax Career Training P-4-10008
TRAINING/INTERNSHIP PLACEMENT PLAN
Each Training/Internship Placement Plan should cover a definite period of time and should consist of definite phases of training or tasks performed
with a specific objective for each phase. The plan must also contain information on how the trainees/interns will accomplish those objectives (i.e.
classes, individual instruction, shadowing, etc.). Each phase must build upon the previous phase to show a progression in the training/internship. A
separate copy of page 2 must be completed for each phase if applicable (i.e.; if the trainee/intern is rotating through different departments).

Name of Trainee/Intern (Last, First, MI) Field of Training/Internship

Name of Phase Start Date for this Phase End Date for this Phase
Restaurant Operations Phase 2 of 5
(mm-dd-yyyy) (mm-dd-yyyy)
Brief Description of Trainee/Intern's Role for this Program or for this Phase

The trainee will receive training in Hospitality and Tourism with an emphasis in Restaurant Management. The trainee will gain
experience and develop management skills by being exposed to day-to-day operation as well as shadowing the management team.

Specific Tasks and Activities to be Completed for this Program or for this Phase (Interns) or Methodology of Training and Chronology/Syllabus for this
Phase (Trainees)

- Train directly with the Restaurant Manager to learn the daily procedures and operations.
- Learn the restaurant menu and daily menu changes.
- Assist with inventory management, replenishing supplies and maintaining equipment.

Specific Goals and Objectives for this Program or for this Phase

During this phase, Trainee1 will learn American standards of upscale quality in relation to the Restaurant’s operations. S/he will learn
procedures through daily operations. S/he will experience the relationship between the operations department and the other areas of
the restaurant.

Knowledge, Skills, or Techniques to be Imparted During this Program or During this Phase

The trainee will become part of the front line of customer service in the restaurant. S/he will learn the restaurant menu and
communicate daily specials to valued guests. As part of the general restaurant management training the trainee will also learn to
keep serving areas stocked with supplies and learn to anticipate restaurant needs.

Methods of Performance Evaluation and Methods or Supervision for this Program or for this Phase

The training advisor will provide day to day supervision and feedback for the trainee. It is the responsibility of the advisor to ensure
the trainee's questions and concerns are addressed. Reviews will be held at the end of each phase to ensure the trainee is prepared
to continue in the program. A final evaluation at the end of the final phase will measure the trainee's overall development and learning.

PRIVACY ACT STATEMENT

AUTHORITIES: The information is sought pursuant to Section 102 of the Mutual Educational and Cultural Exchange Act of 1961, as amended (the
Fulbright-Hays Act)(22 U.S.C. 2452) which provides for the administration of the Exchange Visitor Program (J visa).
PURPOSE: The information solicited on this form is necessary to provide clarity of training and intern programs offered to foreign nationals by United
States entities designated by the Department of State to conduct exchange visitor programs, for general statistical use within the Department of State,
and to enable the Department of State to effectively administer the trainee and intern categories of the Exchange Visitor Program. Failure to provide
the information requested on this form may result in non-participation in the Exchange Visitor Program.
ROUTINE USES: The information on this form may be used in reviewing complaints, in formulating statistical data on training and internships
programs conducted under the Exchange Visitor Program, and may be shared with overseas counterpart offices of the Department of State to ensure
proper administration of this Program for exchange purposes. The information provided may also be released to federal, state, local, or foreign
government entities for law enforcement purposes.
Public reporting burden for this collection of information is estimated to average 2 hours per response, including time required for searching existing
data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection. You do
not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy of this
burden estimate and/or recommendations for reducing it, please send them to: A/GIS/DIR, Room 2400 SA-22, U.S. Department of State, Washington,
DC 20522-2202

DS-7002
Program Sponsor Name Program Number
Intrax Career Training P-4-10008
TRAINING/INTERNSHIP PLACEMENT PLAN
Each Training/Internship Placement Plan should cover a definite period of time and should consist of definite phases of training or tasks performed
with a specific objective for each phase. The plan must also contain information on how the trainees/interns will accomplish those objectives (i.e.
classes, individual instruction, shadowing, etc.). Each phase must build upon the previous phase to show a progression in the training/internship. A
separate copy of page 2 must be completed for each phase if applicable (i.e.; if the trainee/intern is rotating through different departments).

Name of Trainee/Intern (Last, First, MI) Field of Training/Internship

Name of Phase Start Date for this Phase End Date for this Phase
Kitchen Phase 3 of 5
(mm-dd-yyyy) (mm-dd-yyyy)
Brief Description of Trainee/Intern's Role for this Program or for this Phase

The trainee will receive training in Hospitality and Tourism with an emphasis in Restaurant Management. The trainee will gain
experience and develop management skills by being exposed to day-to-day operation as well as shadowing the management team.

Specific Tasks and Activities to be Completed for this Program or for this Phase (Interns) or Methodology of Training and Chronology/Syllabus for this
Phase (Trainees)

- Assist with the overall operations of the kitchen department.

- Assist with processing orders and preparing special requests.
- Address guest requests or complaints in person.
- Review daily statements, and read reports.
- Manage data and information.
- Assist with coordinating and delegating assignments to staff.

Specific Goals and Objectives for this Program or for this Phase

The objective of this phase is to give the trainee an overview of the daily operations in the kitchen department. During this phase of
the training, the participant will be trained in the kitchen department. S/he will become familiar with the daily operations of the
department by processing orders and adhering to strict timelines.

Knowledge, Skills, or Techniques to be Imparted During this Program or During this Phase

The trainee will learn to handle shifts (both AM and PM) and to improve employee efficiency. S/he will develop interpersonal and
leadership skills. The trainee will also learn how the company manages expectations, handles special requests and ensures guest
satisfaction.

Methods of Performance Evaluation and Methods or Supervision for this Program or for this Phase

The training advisor will provide day to day supervision and feedback for the trainee. It is the responsibility of the advisor to ensure the
trainee's questions and concerns are addressed. Reviews will be held at the end of each phase to ensure the trainee is prepared to
continue in the program. A final evaluation at the end of the final phase will measure the trainee's overall development and learning.

PRIVACY ACT STATEMENT

AUTHORITIES: The information is sought pursuant to Section 102 of the Mutual Educational and Cultural Exchange Act of 1961, as amended (the
Fulbright-Hays Act)(22 U.S.C. 2452) which provides for the administration of the Exchange Visitor Program (J visa).
PURPOSE: The information solicited on this form is necessary to provide clarity of training and intern programs offered to foreign nationals by United
States entities designated by the Department of State to conduct exchange visitor programs, for general statistical use within the Department of State,
and to enable the Department of State to effectively administer the trainee and intern categories of the Exchange Visitor Program. Failure to provide
the information requested on this form may result in non-participation in the Exchange Visitor Program.
ROUTINE USES: The information on this form may be used in reviewing complaints, in formulating statistical data on training and internships
programs conducted under the Exchange Visitor Program, and may be shared with overseas counterpart offices of the Department of State to ensure
proper administration of this Program for exchange purposes. The information provided may also be released to federal, state, local, or foreign
government entities for law enforcement purposes.
Public reporting burden for this collection of information is estimated to average 2 hours per response, including time required for searching existing
data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection. You do
not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy of this
burden estimate and/or recommendations for reducing it, please send them to: A/GIS/DIR, Room 2400 SA-22, U.S. Department of State, Washington,
DC 20522-2202

DS-7002
Program Sponsor Name Program Number
Intrax Career Training P-4-10008
TRAINING/INTERNSHIP PLACEMENT PLAN
Each Training/Internship Placement Plan should cover a definite period of time and should consist of definite phases of training or tasks performed
with a specific objective for each phase. The plan must also contain information on how the trainees/interns will accomplish those objectives (i.e.
classes, individual instruction, shadowing, etc.). Each phase must build upon the previous phase to show a progression in the training/internship. A
separate copy of page 2 must be completed for each phase if applicable (i.e.; if the trainee/intern is rotating through different departments).

Name of Trainee/Intern (Last, First, MI) Field of Training/Internship

Name of Phase Start Date for this Phase End Date for this Phase
Restaurant Management - Basic Training Phase 4 of 5
(mm-dd-yyyy) (mm-dd-yyyy)
Brief Description of Trainee/Intern's Role for this Program or for this Phase

The trainee will receive training in Hospitality and Tourism with an emphasis in Restaurant Management. The trainee will gain
experience and develop management skills by being exposed to day-to-day operation as well as shadowing the management team.

Specific Tasks and Activities to be Completed for this Program or for this Phase (Interns) or Methodology of Training and Chronology/Syllabus for this
Phase (Trainees)

- Be exposed to teamwork that is required for a successful management operation.

- Be exposed to the setup and breakdown for events, promotions, etc.
- Assist with different aspects of the restaurant’s services.
- Learn to execute floor plans and operational requirements.

Specific Goals and Objectives for this Program or for this Phase

The main objective of this phase is for the trainee to be exposed to the basic procedures and concepts in restaurant management.
The trainee will learn the daily operations of restaurant management, as well the working environment.

Knowledge, Skills, or Techniques to be Imparted During this Program or During this Phase

S/he will learn to process orders, learn to identify product needs to meet demand, and set up and manage events at the restaurant. S/
he will also learn the restaurant’s customer service methods and techniques. The trainee will learn to manage various projects. S/he
will develop communication and interpersonal skills. This phase of the training will enhance the trainee’s ability to organize, delegate
assignments, and solve daily problems.   

Methods of Performance Evaluation and Methods or Supervision for this Program or for this Phase

The training advisor will provide day to day supervision and feedback for the trainee. It is the responsibility of the advisor to ensure
the trainee's questions and concerns are addressed. Reviews will be held at the end of each phase to ensure the trainee is prepared
to continue in the program. A final evaluation at the end of the final phase will measure the trainee's overall development and
learning.

PRIVACY ACT STATEMENT

AUTHORITIES: The information is sought pursuant to Section 102 of the Mutual Educational and Cultural Exchange Act of 1961, as amended (the
Fulbright-Hays Act)(22 U.S.C. 2452) which provides for the administration of the Exchange Visitor Program (J visa).
PURPOSE: The information solicited on this form is necessary to provide clarity of training and intern programs offered to foreign nationals by United
States entities designated by the Department of State to conduct exchange visitor programs, for general statistical use within the Department of State,
and to enable the Department of State to effectively administer the trainee and intern categories of the Exchange Visitor Program. Failure to provide
the information requested on this form may result in non-participation in the Exchange Visitor Program.
ROUTINE USES: The information on this form may be used in reviewing complaints, in formulating statistical data on training and internships
programs conducted under the Exchange Visitor Program, and may be shared with overseas counterpart offices of the Department of State to ensure
proper administration of this Program for exchange purposes. The information provided may also be released to federal, state, local, or foreign
government entities for law enforcement purposes.
Public reporting burden for this collection of information is estimated to average 2 hours per response, including time required for searching existing
data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection. You do
not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy of this
burden estimate and/or recommendations for reducing it, please send them to: A/GIS/DIR, Room 2400 SA-22, U.S. Department of State, Washington,
DC 20522-2202

DS-7002
Program Sponsor Name Program Number
Intrax Career Training P-4-10008
TRAINING/INTERNSHIP PLACEMENT PLAN
Each Training/Internship Placement Plan should cover a definite period of time and should consist of definite phases of training or tasks performed
with a specific objective for each phase. The plan must also contain information on how the trainees/interns will accomplish those objectives (i.e.
classes, individual instruction, shadowing, etc.). Each phase must build upon the previous phase to show a progression in the training/internship. A
separate copy of page 2 must be completed for each phase if applicable (i.e.; if the trainee/intern is rotating through different departments).

Name of Trainee/Intern (Last, First, MI) Field of Training/Internship

Name of Phase Start Date for this Phase End Date for this Phase
Phase 5 of 5
(mm-dd-yyyy) (mm-dd-yyyy)
Brief Description of Trainee/Intern's Role for this Program or for this Phase

The trainee will receive training in Hospitality and Tourism with an emphasis in Restaurant Management. The trainee will gain
experience and develop management skills by being exposed to day-to-day operation as well as shadowing the management team.

Specific Tasks and Activities to be Completed for this Program or for this Phase (Interns) or Methodology of Training and Chronology/Syllabus for this
Phase (Trainees)

The following activities will allow the trainee to develop a comprehensive understanding of the procedures:
- Participate as a member of the team during restaurant promotions and events: the trainee will perform in different roles during each
event.
- Communicate with guests to meet specifications and address questions and concerns.
- Review the statements and financial reports.
- Participate and assist with service team meetings.
- Training in management and leadership.
- Personnel management training: assist with scheduling shifts, evaluating performance, and handling discipline.
- Assist with organizing events and promotions.
- Participate in business planning.
Specific Goals and Objectives for this Program or for this Phase

The objective of this phase is so the trainee will continue to gain exposure to the management operations of the restaurant. This
phase will use the objective from the previous phase, and will build upon that so the trainee will gain an advanced training in the daily
operations of restaurant management

Knowledge, Skills, or Techniques to be Imparted During this Program or During this Phase

S/he will become familiar with the special menus and develop customer service skills through direct interaction with guests.
Depending on the motivation, progress and drive of the trainee, s/he will have an opportunity to handle special supervisory projects.
This may include planning events with clients, reserving space for special events, establishing floor plans, scheduling staff, organizing
promotions and anticipating customer needs.

Methods of Performance Evaluation and Methods or Supervision for this Program or for this Phase

The training advisor will provide day to day supervision and feedback for the trainee. It is the responsibility of the advisor to ensure the
trainee's questions and concerns are addressed. Reviews will be held at the end of each phase to ensure the trainee is prepared to
continue in the program. A final evaluation at the end of the final phase will measure the trainee's overall development and learning.

PRIVACY ACT STATEMENT

AUTHORITIES: The information is sought pursuant to Section 102 of the Mutual Educational and Cultural Exchange Act of 1961, as amended (the
Fulbright-Hays Act)(22 U.S.C. 2452) which provides for the administration of the Exchange Visitor Program (J visa).
PURPOSE: The information solicited on this form is necessary to provide clarity of training and intern programs offered to foreign nationals by United
States entities designated by the Department of State to conduct exchange visitor programs, for general statistical use within the Department of State,
and to enable the Department of State to effectively administer the trainee and intern categories of the Exchange Visitor Program. Failure to provide
the information requested on this form may result in non-participation in the Exchange Visitor Program.
ROUTINE USES: The information on this form may be used in reviewing complaints, in formulating statistical data on training and internships
programs conducted under the Exchange Visitor Program, and may be shared e trainee7
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Program Sponsor Name Program Number
Intrax Career Training P-4-10008
TRAINING/INTERNSHIP PLACEMENT PLAN
Each Training/Internship Placement Plan should cover a definite period of time and should consist of definite phases of training or tasks performed
with a specific objective for each phase. The plan must also contain information on how the trainees/interns will accomplish those objectives (i.e.
classes, individual instruction, shadowing, etc.). Each phase must build upon the previous phase to show a progression in the training/internship. A
separate copy of page 2 must be completed for each phase if applicable (i.e.; if the trainee/intern is rotating through different departments).

Name of Trainee/Intern (Last, First, MI) Field of Training/Internship

Name of Phase Start Date for this Phase End Date for this Phase
Phase of
(mm-dd-yyyy) (mm-dd-yyyy)
Brief Description of Trainee/Intern's Role for this Program or for this Phase

Specific Tasks and Activities to be Completed for this Program or for this Phase (Interns) or Methodology of Training and Chronology/Syllabus for this
Phase (Trainees)

Specific Goals and Objectives for this Program or for this Phase

Knowledge, Skills, or Techniques to be Imparted During this Program or During this Phase

Methods of Performance Evaluation and Methods or Supervision for this Program or for this Phase

PRIVACY ACT STATEMENT

AUTHORITIES: The information is sought pursuant to Section 102 of the Mutual Educational and Cultural Exchange Act of 1961, as amended (the
Fulbright-Hays Act)(22 U.S.C. 2452) which provides for the administration of the Exchange Visitor Program (J visa).
PURPOSE: The information solicited on this form is necessary to provide clarity of training and intern programs offered to foreign nationals by United
States entities designated by the Department of State to conduct exchange visitor programs, for general statistical use within the Department of State,
and to enable the Department of State to effectively administer the trainee and intern categories of the Exchange Visitor Program. Failure to provide
the information requested on this form may result in non-participation in the Exchange Visitor Program.
ROUTINE USES: The information on this form may be used in reviewing complaints, in formulating statistical data on training and internships
programs conducted under the Exchange Visitor Program, and may be shared with overseas counterpart offices of the Department of State to ensure
proper administration of this Program for exchange purposes. The information provided may also be released to federal, state, local, or foreign
government entities for law enforcement purposes.
Public reporting burden for this collection of information is estimated to average 2 hours per response, including time required for searching existing
data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection. You do
not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy of this
burden estimate and/or recommendations for reducing it, please send them to: A/GIS/DIR, Room 2400 SA-22, U.S. Department of State, Washington,
DC 20522-2202

DS-7002
Program Sponsor Name Program Number
Intrax Career Training P-4-10008
TRAINING/INTERNSHIP PLACEMENT PLAN
Each Training/Internship Placement Plan should cover a definite period of time and should consist of definite phases of training or tasks performed
with a specific objective for each phase. The plan must also contain information on how the trainees/interns will accomplish those objectives (i.e.
classes, individual instruction, shadowing, etc.). Each phase must build upon the previous phase to show a progression in the training/internship. A
separate copy of page 2 must be completed for each phase if applicable (i.e.; if the trainee/intern is rotating through different departments).

Name of Trainee/Intern (Last, First, MI) Field of Training/Internship

Name of Phase Start Date for this Phase End Date for this Phase
Phase of
(mm-dd-yyyy) (mm-dd-yyyy)
Brief Description of Trainee/Intern's Role for this Program or for this Phase

Specific Tasks and Activities to be Completed for this Program or for this Phase (Interns) or Methodology of Training and Chronology/Syllabus for this
Phase (Trainees)

Specific Goals and Objectives for this Program or for this Phase

Knowledge, Skills, or Techniques to be Imparted During this Program or During this Phase

Methods of Performance Evaluation and Methods or Supervision for this Program or for this Phase

PRIVACY ACT STATEMENT

AUTHORITIES: The information is sought pursuant to Section 102 of the Mutual Educational and Cultural Exchange Act of 1961, as amended (the
Fulbright-Hays Act)(22 U.S.C. 2452) which provides for the administration of the Exchange Visitor Program (J visa).
PURPOSE: The information solicited on this form is necessary to provide clarity of training and intern programs offered to foreign nationals by United
States entities designated by the Department of State to conduct exchange visitor programs, for general statistical use within the Department of State,
and to enable the Department of State to effectively administer the trainee and intern categories of the Exchange Visitor Program. Failure to provide
the information requested on this form may result in non-participation in the Exchange Visitor Program.
ROUTINE USES: The information on this form may be used in reviewing complaints, in formulating statistical data on training and internships
programs conducted under the Exchange Visitor Program, and may be shared with overseas counterpart offices of the Department of State to ensure
proper administration of this Program for exchange purposes. The information provided may also be released to federal, state, local, or foreign
government entities for law enforcement purposes.
Public reporting burden for this collection of information is estimated to average 2 hours per response, including time required for searching existing
data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection. You do
not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy of this
burden estimate and/or recommendations for reducing it, please send them to: A/GIS/DIR, Room 2400 SA-22, U.S. Department of State, Washington,
DC 20522-2202

DS-7002