Cap Program Extension Form

Personal information

First Name*

Last Name*

Greenheart Exchange Online ID Number*

Email Address*

Program & Date information

Program Option*

Name of Host Organization*

Current DS Start Date*

Current DS End Date*

Requested New End Date*

Reason for request

Why do you want to extend your program?*

How would an extension benefit you intern/training program?*

Conditions of Greenheart Exchange CAP Program Extension:*

By checking this box and submitting my J-1 program extension request, I understand that granting of this request is contingent on approval from Greenheart Exchange and my current Greenheart Exchange-approved Host Organization. I also understand that the request for program extension applies only to my current position in my Host Organization named above. If my request is approved, I understand that I am responsible for paying all applicable fees (as detailed in the participant handbook), and that these fees are subject to change. I also understand that in order to receive final approval, I will be required to submit a new DS-7002 Training Plan outlining the details of the remainder of my training period.

I agree