SCHEDULE A NURSE GREEN CARD CHECKLIST FOR INTERNATIONAL PERSONNEL
We are working on the Schedule A green card preparation process regarding the position offered to you. We need you to provide us with information and documents below. It is very likely that we will ask you for more information or documents depending on your answers to this checklist.We appreciate your cooperation and patience throughout the process.
Enter Name of U.S. Employer + Name of International Personnel
Full legal name
First Name
Middle Name
Last Name
Any other names, if ever used
Contact information
Cell Phone Number
Please enter a valid phone number.
Email
Address in the U.S.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Address Abroad
Street Address
Street Address Line 2
City
State
Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Birth Information
Birthdate
-
Month
-
Day
Year
Date
Town of Birth
Province of Birth
Country of Birth
UPLOAD Certificate of Birth with English translation, if not in English
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Citizenship
Country of Citizenship
Additional Country(ies) of Citizenship, if any
Passport Information
Passport number
Date Passport was Issued
-
Month
-
Day
Year
Date
Date Passport will Expire
-
Month
-
Day
Year
Date
UPLOAD a copy of the bio page of your current passport
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Social Security
U.S. Social Security Number, if any
Current U.S. Visa information, if applicable
Type of Visa
U.S. Consulate where visa was issued
Date visa was issued
-
Month
-
Day
Year
Date
Visa number
UPLOAD a copy of your current U.S. visa
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Last U.S. Entry
Date of last entry
-
Month
-
Day
Year
Date
What status you entered in
I-94 number
I-94 expiration date
-
Month
-
Day
Year
Date
UPLOAD your latest I-94 from https://i94.cbp.dhs.gov/I94/#/home
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UPLOAD your travel history from https://i94.cbp.dhs.gov/I94/#/history-search
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Any periods of stay in the U.S. in H-1B or L-1 status (list all), if applicable
Date H-1B or L-1 status began
-
Month
-
Day
Year
Date
Date Status expired
-
Month
-
Day
Year
Date
Name of previous Employer
UPLOAD previous H-1B/L-1 approval notices
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UPLOAD previous H-1B/L-1 visas
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Any period of stay in F-1 student status, if applicable
UPLOAD copy(ies) of F-1 student visa(s)
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UPLOAD your most recent I-20s
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UPLOAD all previous I-20s
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UPLOAD a copy of all OPT/STEM OPT EADs (front and back)
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Any period of stay in J-1 status, if applicable
Please provide dates
UPLOAD all DS-2019s
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Have you or anyone on your behalf ever applied for permanent resident including labor certification, I-140, or any other petitions or applications?
If so, provide dates and copies
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Please provide dates
EDUCATION - Undergraduate 1
Type of Degree
List your major
Date degree was conferred
-
Month
-
Day
Year
Date
What college/university?
UPLOAD diploma
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UPLOAD transcripts
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EDUCATION - Undergraduate 2
Type of Degree
List your major
Date degree was conferred
-
Month
-
Day
Year
Date
What college/university?
UPLOAD diploma
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UPLOAD transcripts
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EDUCATION - Graduate Degree 1
Type of Degree
List your major
Date degree was conferred
-
Month
-
Day
Year
Date
What college/university?
UPLOAD diploma
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UPLOAD transcripts
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EDUCATION - Graduate Degree 2
Type of Degree
List your major
Date degree was conferred
-
Month
-
Day
Year
Date
What college/university?
UPLOAD diploma
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Experience
UPLOAD your most current CV/Resume
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UPLOAD US RN license, if any
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Have you passed NCLEX? If not, have you scheduled to take it?
UPLOAD Screenshot/evidence of passing NCLEX, if any
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Do you have a CGFNS Certification?
UPLOAD CGFNS Certification, if any
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UPLOAD Credential Diploma, if any
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UPLOAD results of TOEFL, TOEIC and IELTS tests, if any
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Do you have an employment authorization document? If not, have you applied for one?
UPLOAD current and previous employment authorization documents (front and back)
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Problems with the Law
Have you ever had any problems with the law in the U.S. or anywhere in the world?
*
Denials and Removal
Has the U.S. Consulate, USCIS, or U.S. Customs and Border Patrol ever denied your visa application, petition, or request for admission?
*
Have you ever been in removal (deportation proceedings) in the U.S.? Have you ever been in the U.S. out of status?
*
Family
Will any family members (spouse, children) immigrate with you?
Spouse, if any
Full legal name
First Name
Middle Name
Last Name
Birthdate
-
Month
-
Day
Year
Date
Email
Cell Phone Number
Please enter a valid phone number.
Place of Birth
UPLOAD bio page of current passport
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UPLOAD Birth Certificate with English translation, if not in English
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UPLOAD Marriage Certificate with English translation, if not in English
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UPLOAD previous approval notices
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UPLOAD latest I-94 from https://i94.cbp.dhs.gov/I94/#/home
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https://i94.cbp.dhs.gov/I94/#/home
UPLOAD travel history from https://i94.cbp.dhs.gov/I94/#/history-search
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https://i94.cbp.dhs.gov/I94/#/history-search
Child #1, if any
Full legal name
First Name
Middle Name
Last Name
Birthdate
-
Month
-
Day
Year
Date
Email
Cell Phone Number
Please enter a valid phone number.
Place of Birth
UPLOAD bio page of current passport
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UPLOAD Birth Certificate with English translation, if not in English
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UPLOAD previous approval notices
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UPLOAD latest I-94 from https://i94.cbp.dhs.gov/I94/#/home
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https://i94.cbp.dhs.gov/I94/#/home
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Child #2, if any
Full legal name
First Name
Middle Name
Last Name
Birthdate
-
Month
-
Day
Year
Date
Email
Cell Phone Number
Please enter a valid phone number.
Place of Birth
UPLOAD bio page of current passport
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UPLOAD Birth Certificate with English translation, if not in English
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UPLOAD previous approval notices
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UPLOAD latest I-94 from https://i94.cbp.dhs.gov/I94/#/home
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https://i94.cbp.dhs.gov/I94/#/home
UPLOAD travel history from https://i94.cbp.dhs.gov/I94/#/history-search
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Child #3, if any
Full legal name
First Name
Middle Name
Last Name
Birthdate
-
Month
-
Day
Year
Date
Email
Cell Phone Number
Please enter a valid phone number.
Place of Birth
UPLOAD bio page of current passport
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UPLOAD Birth Certificate with English translation, if not in English
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UPLOAD previous approval notices
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UPLOAD latest I-94 from https://i94.cbp.dhs.gov/I94/#/home
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https://i94.cbp.dhs.gov/I94/#/home
UPLOAD travel history from https://i94.cbp.dhs.gov/I94/#/history-search
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https://i94.cbp.dhs.gov/I94/#/history-search
If you have more than 3 children, please list their names and dates of birth here
Are your parents, spouse, or children U.S. citizens or permanent residents? If so, please provide name, date of birth and immigration status
If you need to provide us with additional information, please provide it here:
Additional Information
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Thank you.
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