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APPLICATION FORM for H2B VISA PROGRAM by DerekFine

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									               APPLICATION FORM for H-2B VISA PROGRAM

              I. Passport Information
   Country where Passport was Issued
   Passport Number
   Date Passport Issued
   Date Passport Expires
   Is Worker Returning On an H-2B Visa?
   Social Security #
   Date of Arrival
   Date H-2B Expires
                                 II. Applicant information
Program (intern/trainee)

First name
Middle name
Last / Family name
Gender
Date of birth
City of birth
Country of birth
Permanent Residence
Country of Citizenship
How did you hear about
UKRPERSONAL
                              III. Permanent contact information
Street address
City
Postal code
Country
Email address
Telephone number
                                  IV. University Information
Current University Name
University address:
        Street address
        City
        Province/region
        Postal Code
        Country
Field of Study
Course
Qualification
                              V. Secondary School Information
Secondary School Number
When did you graduate
from the secondary school?
If you didn’t graduate from
the secondary school, how
many classes have you
finished?
        City
        Province/region
        Postal Code
        Country
                                     VI. English skills
Beginner/Elementary level
Pre-intermediate level
Intermediate level
Upper intermediate level
Advanced level
                                 VII. Employment history
Name of organization № 1
Position
Duties
Professional skills
From – to (date)

Name of organization № 2
Position
Duties
Professional skills
From – to (date)

Name of organization № 3
Position
Duties
Professional skills
From – to (date)
  U. S. Host Organization (Host Company) Position and Contact information              (for
                                       SELP-PLACED)
Name of your prospective
U. S. Host Organization
         Prospective supervisor’s contact information at the U. S. Host Organization
                                    (for SELP-PLACED)
Last/Family name
First name
Title
Street address
City
State
Zip Code
Email address

								
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