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Check List For Green Card by cutiepie1336

VIEWS: 67 PAGES: 13

									                   GREEN CARD CHECKLIST - Nurses

1. _______ THIS CLIENT INTAKE FORM starting on next page (Please Complete as
   much as you can)
           NOTE: EMPLOYER INFORMATION BEGINS AT PAGE 10

2. ______ First four pages from the Passport of Alien (including showing validity)

3. ______ Resume, Bio-data or C.V.

4. ______ Employee education: Degree Certificates

5. ______ Photocopy of High School diploma

6. ______ TOEFL Exam

7. ______ CGFNS Exam for Nurses

8. ______ License Certificates

9. ______ Training / Experience Letters from Prior Employers including:

               Include Dates worked, job title Detail Description of work, projects, etc.

10. ______ Employer Info (that is Hiring Petitioner information)

NOTES:

______ Official Transcripts of your coursework in nursing program showing hours

worked in classroom and hours as clinical practice must be directly mailed to ICHP

______ TOEFL Exam scores must be directly sent to ICHP; min. score is 540 or for

computer version is 207 (taken within 2 years)

______ Verification of License to practice must be sent directly to ICHP

If you are in US

   1. ______ I-94 (Copy both sides) & other Proofs of Valid Status since Entry in the

       United States such as ALL Prior I-797 Approval Notices, I-94's, I-20's or J-1 visa

       forms
                                  CLIENT INTAKE

           Information about the Candidate (Alien)
1.    Last Name__________________________________________
2.    First Name__________________________________________
3.    Initial______________
4.    Address____________________________________________
      ________________________________________________________________

5.              Apartment__________
6.              City________________
7.              State_______________
8.              Zip Code____________
9.              Country__________________________
10.             Home Phone____________________________
11. Alternate #_______________________
12. E-Mail___________________________
13. Sex_____________________________
14. Country of Citizenship_________________________________
15. Marital Status_____________________
16. Date of Birth______________________
17. City of Birth_______________________
18. Country of Birth____________________
19. Social Security_____________________
20. Date of 1st Arrival___________________
21. I-94 #_____________________________________________
22. Current Status_____________________
23. I-94 Expires_______________________
24. Recent Foreign Address________________________________
      ___________________________________________________
25. Are you filing for any dependents_______________________
26. Is this a New Employment_____________________________
27. Have you ever been granted H-1 visa before:______________
      If Yes:
28. Provide LIN#____________________________________
   29. List Prior Periods of Stay in H Classification (Exclude the periods      when you were outside of
       USA; Example: Trip To Back Home)
       ___________________________________________________
       ___________________________________________________
   30. List Prior Periods of Stay in H Classification for Dependents (if
                any)________________________________________________
                ___________________________________________________
                ___________________________________________________
                ___________________________________________________

   31. Alien Educational Background (List all Degrees AND              Professional Certifications)


   32. College/University Name________________________________
   33. City_________________________
   34. State________________________
   35. Country______________________
   36. Starting Date__________________
   37. Graduation Date________________
   38. Field of Study________________________________________
   39. Degree Obtained______________________________________




Additional Degrees


   40. College/University Name________________________________
   41. City_________________________
   42. State________________________
   43. Country______________________
   44. Starting Date__________________
   45. Graduation Date________________
   46. Field of Study________________________________________
   47. Degree Obtained______________________________________


Additional Degrees
48. College/University Name________________________________
49. City_________________________
50. State________________________
51. Country______________________
52. Starting Date__________________
53. Graduation Date________________
54. Field of Study________________________________________
55. Degree Obtained______________________________________


56. Additional Certifications_____________________________________

                          Use an additional sheet of paper if necessary


57. Alien PRIOR EMPLOYMENT INFORMATION
    List all employers for past 5 years (most recent first)


58. Name of Employer ____________________________________
59. Address_____________________________________________
60. City_________________________
61. State________________________
62. Zip Code_____________________
63. Position______________________
64. Starting Date__________________
65. End Date_____________________


66. Responsibilities (Provide 1 Paragraph):_____________________
    ___________________________________________________
    ___________________________________________________
    ___________________________________________________
    ___________________________________________________
    ___________________________________________________
    ___________________________________________________
    ___________________________________________________
    ___________________________________________________
    ___________________________________________________
    ___________________________________________________
    ___________________________________________________
    ___________________________________________________
       ___________________________________________________
       ___________________________________________________


Prior Employer


   67. Name of Employer ____________________________________
   68. Address_____________________________________________
   69. City_________________________
   70. State________________________
   71. Zip Code_____________________
   72. Position______________________
   73. Starting Date__________________
   74. End Date_____________________


   75. Responsibilities (Provide 1 Paragraph):_____________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________


Prior Employer


   76. Name of Employer ____________________________________
   77. Address_____________________________________________
   78. City_________________________
   79. State________________________
   80. Zip Code_____________________
   81. Position______________________
   82. Starting Date__________________
   83. End Date_____________________


   84. Responsibilities (Provide 1 Paragraph):_____________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________


Prior Employer


   85. Name of Employer ____________________________________
   86. Address_____________________________________________
   87. City_________________________
   88. State________________________
   89. Zip Code_____________________
   90. Position______________________
   91. Starting Date__________________
   92. End Date_____________________


   93. Responsibilities (Provide 1 Paragraph):_____________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________


Prior Employer


   94. Name of Employer ____________________________________
   95. Address_____________________________________________
   96. City_________________________
   97. State________________________
   98. Zip Code_____________________
   99. Position______________________
   100.Starting Date__________________
   101.End Date_____________________


   102.Responsibilities (Provide 1 Paragraph):_____________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
Use an additional sheet of paper if necessary
                                EMPLOYER INFORMATION

1.     Company Name_______________________________________
2.     Address_____________________________________________
3.     Suite___________________________
4.     City____________________________
5.     State___________________________
6.     Zip Code________________________
7.     Website_____________________________________________
8.     Phone #________________________
9.     Fax #__________________________
10. E-Mail______________________________________
11. Name of Representative Who Will Sign_______________
12. Title___________________________________________
13. Year Business Incorporated______________________
14. Total # of Employees___________________________
15. Federal Tax I.D._______________________________
16. Gross Annual Revenue $________________________
17. Net Annual Revenue $__________________________
18. Projected Revenue $___________________________
19. Type Of Business_____________________________________
       ___________________________________________________
20. Job Title____________________________________________
21. Address where Employment is Located____________________
       ___________________________________________________
22. Corporate Benefits Offered $____________________________
23. Dates of Intended Employment__________________________
24. Basic Salary Offered $_________________________________


25. Background of Employer (Please provide any newspaper       articles, brochures,
    business plans, etc.)
        ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
       ___________________________________________________
        ___________________________________________________
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        ___________________________________________________


26. Description of Job Offered (Provide Detailed Duties to be   Performed; Also please provide %
    of time spent in task)
        Tasks                                                           % of time
        ___________________________________________________
        ___________________________________________________
        ___________________________________________________
        ___________________________________________________
        ___________________________________________________
        ___________________________________________________
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27.   Project Description____________________________________
      ___________________________________________________
      ___________________________________________________
      ___________________________________________________
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           ___________________________________________________
           ___________________________________________________
           ___________________________________________________
           ___________________________________________________
           ___________________________________________________
           ___________________________________________________
           ___________________________________________________

complete this section if you are applying for a Computer/Technical position

List your skills in each area below:



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