Free Online Assessment

Part 1 A - Initial Eligibility Determination
(Citizens of Canada and Mexico only)





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Part 1 B - Initial Eligibility Determination
(Citizens of countries other than Canada and Mexico)




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Part 2 - Personal Information
(Double-Check all information and verify that it is correct)

Last Name (Required)

First Name (Required)

Gender (Required)

Email (Required)
(This is how we will contact you!)

Country of Citizenship (Required)

Country of Residency (Required)

Phone Number (Required)

(Ex.14165551212)

 I have previously held a US employment-based Visa.
(If yes, please explain providing information regarding the type of visa, the dates of validity and any other relevant details:)

 I have been previously denied a US Visa.
(If yes, please explain the circumstances of the denial:)

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Part 3 - US Job Offer
(Applicable only if given a job offer from a US Employer)

US Employer
(Name of the employer offering the job)

Location
(City, State)

Position Being Offered

 Foreign Affiliate
(Do you currently work for a foreign affiliate of the above-named US employer? If yes, complete the following 4 form-fields.)

Name of Current Employer

Job Title
(Your Position)

Length of Employment
(Years, Months)

Description of Current Duties

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Part 4 Curriculum Vitae
(Résumé / Biodata)
Please upload either a .pdf or a .doc file of your most current CV (FILE SIZE LIMIT: 500kb)

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Part 5 - Help Us Help You!
(Is there anything else we should know about you?)

Please use the following text box to provide any additional relevant information regarding your inquiry, or to raise any questions, comments or concerns about your personal situation.

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