Part 9. Complete Only If Filing a Special Immigrant Religious Worker Petition (continued)
3.
Beneficiary
Family Name (Last Name)
Given Name (First Name)
Middle Name
Period of Stay
From (mm/dd/yyyy)
To (mm/dd/yyyy)
4.
Provide a summary of the type of responsibilities of those employees, other than the beneficiary, who work at the same location
where the beneficiary will be employed. If you need extra space to complete this section, use the space provided in Part 15.
Additional Information.
Position
Summary of the Type of Responsibilities for That Position
5.
Describe the relationship, if any, between the religious organization in the United States and the organization abroad of which
the beneficiary is a member.
6.
Provide the following information about the prospective employment. If you need extra space to complete this section, use the
space provided in Part 15. Additional Information.
A. Title of position offered
B. The beneficiary will be working (select one of the following):
As a minister
In a religious vocation
In a religious occupation
C. Detailed description of the beneficiary's proposed daily duties
D. Description of the beneficiary's qualifications for the position offered
E. Description of the proposed salaried and/or non-salaried compensation
F. Provide the specific addresses or locations where the beneficiary will be working
Company Name
Street Number and Name
Apt.
Ste.
Flr. Number
City or Town
State
ZIP Code
Province
Postal Code
Country
Form I-360 12/23/16 N
Page 10 of 19