H1B/EB3 VISA JOB APPLICATION FORM
Thank you for your interest in working in the United States. Please complete this form with accurate information. Incomplete applications may not be processed.
SECTION 1: PERSONAL INFORMATION
Full Name
*
First Name
Last Name
Date Of Birth
*
-
Month
-
Day
Year
Date
Nationality:
*
Gender
*
Please Select
Female
Male
Other
Marital Status
*
Please Select
Single
Married
Divorced
Widowed
Address
*
Street Address
Street Address Line 2
City
State / Province/Parish
Postal / Zip Code
Phone Number
*
E-mail
*
example@example.com
Preferred Contact Method:
*
Please Select
Phone
Email
WhatsApp
Do you have a valid passport?
*
Yes
No
If yes, expiration date: (MM/DD/YYYY)
*
-
Month
-
Day
Year
Date
Do you have any dependents (spouse/children) that will relocate with you?
*
Yes
No
If yes, how many?
Do you have any U.S. relatives?
*
Yes
No
If yes, where are they located?
SECTION 2: VISA HISTORY
Have you ever applied for a U.S. visa?
*
Yes
No
If yes, what type?
Please Select
Tourist
Student
H1B
H2B
EB3
Other
Was it approved?
*
Yes
No
If denied, what was the reason?
Have you ever lived or worked in the U.S.?
*
Yes
No
If yes, what visa type?
Dates of stay:
-
Month
-
Day
Year
From
-
Month
-
Day
Year
To
Are you currently in the U.S.?
*
Yes
No
If yes, what visa are you on?
What visa are you applying for?
*
H1B (Specialty Occupations – IT, Healthcare, Engineering, etc.)
EB3 (Skilled & Professional Work that Leads to Permanent Employment-Based Green Card)
SECTION 3: EDUCATION & QUALIFICATIONS
Highest Level of Education
*
Please Select
High School
Diploma
Bachelor’s
Master’s
Ph.D
Field of Study
*
University/College Name
*
Graduation Year
*
-
Month
-
Day
Year
Date
Do you have a professional license for the job you're applying for?
*
Yes
No
If yes, specify
Issuing country
*
Professional Certifications (if any)
Are you fluent in English?
*
Yes
No
Other Languages Spoken
SECTION 4: EMPLOYMENT HISTORY
Which job category are you applying for? (Select the closest match to your expertise)
*
Healthcare (Nurse, Doctor, Therapist)
Teaching/Education (K-12, Special Ed, College Instructor)
IT & Engineering (Software Developer, Data Analyst, Network Engineer)
Skilled Trades (Welders, Electricians, Mechanics, CNC Operators)
Hospitality (Hotel Managers, Chefs, Housekeeping Supervisors)
Finance & Business (Accountants, Financial Analysts, HR Professionals)
How many years of experience do you have in this position?
*
Are you open to training or additional certification if required?
*
Yes
No
Do you have U.S. licensing or credential evaluation?
*
Yes
No
If yes, specify
*
(List your most recent jobs starting with the latest.)
Most recent Jobs
Job Title
*
Employer Name
*
Location (City, Country)
*
Supervisor
*
Employment Period
*
-
Month
-
Day
Year
From
*
-
Month
-
Day
Year
To
Job Responsibilities
*
Job Title
*
Employer Name
*
Location (City, Country)
*
Supervisor
*
Employment Period
*
-
Month
-
Day
Year
From
*
-
Month
-
Day
Year
To
Job Responsibilities
*
Do you currently have a job?
*
Yes
No
What is your expected salary in the U.S.?
*
Are you willing to relocate anywhere in the U.S.?
*
Yes
No
If no, what are your preferred locations?
SECTION 5: PROFESSIONAL REFERENCES
Full Name
*
First Name
Last Name
Relationship
*
Company Name
*
Contact Number
*
Email
*
Full Name
*
First Name
Last Name
Relationship
*
Company Name
*
Contact Number
*
Email
*
SECTION 6: DOCUMENT UPLOAD
Upload Resume
*
Browse Files
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Choose a file
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of
Upload a copy of your unexpired passport.
*
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of
Current or Previous U.S. Visa (if applicable)
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of
Upload a professional photo.
*
Browse Files
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Choose a file
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of
Educational Certificates & Diplomas
*
Browse Files
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Cancel
of
Professional Licenses (Nursing, Teaching, IT, etc.)
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Briefly describe your background, skills, and why you are interested in this role.
*
What makes you a strong candidate for this role? Highlight your skills and experience relevant to the position.
*
SECTION 7: EMERGENCY CONTACT
Emergency Contact Name:
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Relationship
*
SECTION 8: CONSENT & DECLARATION
Where Did You Hear About Us?
*
Employer
Referral
TikTok
Facebook
Indeed
LinkedIn
Company Website
Google Search
Other
By signing below, I certify that all information provided in this application is accurate and truthful. I understand that any false statements may result in disqualification. I consent to my information being used for recruitment purposes.
*
Date
*
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Month
-
Day
Year
Date
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