Employer Section: Please read and complete the following section below (use additional paper if necessary).
Date: (month /day/year) / /
I hereby certify that,
name of student student’s country
has been offered employment with our company,
name of company
Tax ID Number:
city state zip
Contact Person (and title):
Dates of Employment* (month /day/year) Start:
/ / *(maximum four months)
Wage per hour (excluding tips and/or bonuses):
Average number of work hours per week:
Housing Available: Yes No Housing Deposit (if any):
Please describe type of business and job:
Housing cost per week/month (if any):
Please use the space below to describe the housing provided or how you will assist in finding
housing for your employees (InterExchange employers are responsible for housing students). Also, use the space provided for any comments, contractual
obligations and additional information regarding the employment of this prospective employee (bonuses, benefits, etc.) Attach a separate sheet if needed.
IMPORTANT ** An InterExchange representative will be in contact with the employer at his/her place of business to verify the information on this agreement.