Data Sheet To Be Completed By H-1b Beneficiary Page 3

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If yes, provide the name and address of the US University which conferred your diploma
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
If you have earned a degree in a country other than the US, is the diploma in English? ______________________________
If not, has it been translated into English? _______
Have you obtained a US equivalency evaluation of the degree earned in another country? ____________________________
NOTE: With this form, provide a copy of your highest earned diploma (and transcripts if they are available) which qualifies
you to work at MUSC whether degree was earned in the US or another country
Your Present Employer _____________________________
Your Present Occupation____________________________
Position held since ________________________________
Provide the names and locations of each past employer, the position you held there and the dates of your employment. Do not
include student employment while in school. (MUSC is required to provide your work experience to USCIS with our petition
for H-1B status).
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
I certify the information above is accurate to the best of my knowledge and is provided for purposes of MUSC’s petition for
my H-1B work authorization at MUSC.
Signature _______________________________________
Date ___________________________________________

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