H-1b Beneficiary Information Form Page 2
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3Please list all previous stays in the U.S. Exclude visits with a B (tourist or visitor for business) visa.
Include your visa classification, dates of stay, and sponsoring institution
Do you have any plans to travel outside of the US between now and the start date of this petition?
__No __Yes If yes, please list dates of travel:
Consult with ISSS before finalizing travel plans.
Highest degree held relevant to the offered position ___ Bachelor’s ___ Master’s ___ Doctorate
Major field(s) of study ___________________________________________________
Year degree completed ____________ Institution _____________________________________
Address of institution ___________________________________________________________________
Dependents (Spouse and Children under the Age of 21)
Do you have any dependents who will be included in this application? ___Yes ___ No
If yes, how many? _____
For initial petitions, please see instructions for completing Form I-539 Change of Status.
Provide the following information for each dependent:
Name (Last/family, First):
Relationship ___ Spouse ___ Child
Date of Birth:
City and Country of Birth:
Country of Citizenship:
If presently in the U.S.:
Current Immigration Status:
Date of Most Recent Arrival in the U.S.:
I-94 Number and Expiration Date:
Visa Expiration Date:
Name (Last/family, First):
Relationship ___ Spouse ___ Child
Date of Birth:
City and Country of Birth:
Country of Citizenship:
If presently in the U.S.:
Current Immigration Status:
Date of Most Recent Arrival in the U.S.:
I-94 Number and Expiration Date:
Visa Expiration Date:
Name (Last/family, First):
Relationship ___ Spouse ___ Child
Date of Birth:
City and Country of Birth:
Country of Citizenship:
If presently in the U.S.:
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