H-1B Information Sheet
(Wake Forest University Center for International Studies: Reynolda Campus)

Last Name:
First Name:
Middle Name(s):
Date of Birth: Year
Social Security Number (if applicable)
   
e-mail address:
   
Current Mailing Address/U.S. Residence:
   
Foreign Address:
   
Telephone No.(work):
Telephone No.(mobile):
Country of Birth:
Country of Citizenship:
State/Province of Birth:
City of Birth:
 
Passport Number:
Date Passport Issued:
Date Passport Expires:
Issuing Country:
 
If you are a new employee and have not yet started work, please provide the estimated start date of your employment at Wake Forest University:
Year
 
If Currently in the U.S., please answer the following questions:
   

Date of most recent arrival in the U.S.(date found on I-94 card):
Year

   
I-94 Number:
   
Current nonimmigrant status (i.e.H-1B, J-1, F-1, etc.):
 
Expiration date of current nonimmigrant status:
Year
 

Have you ever applied for a change of nonimmigrant status from the USCIS?
Yes No

If "Yes," what type of status change did you request?


Was the change of status approved?
Yes No
   

Are you currently working in the U.S. on the optional practical training (OPT) program in conjunction with your F-1 status?
Yes No

 
If so, what is the expiration date listed on your employment authorization document (EAD Card)?
Year
 
Are you currently working in the U.S. on the J-1 academic training program?
Yes No

 
If "Yes," what is the end date for your period of academic training?
Year
Do you have any dependents who will be included in your H-1B application?
Yes No

(If "yes," you will need to complete Form I-539 and submit it to the WFU Center for Int'l Studies so that it can be submitted with the H-1 petition; please be mindful of the fact that this is considered to be a personal application and is not associated with WFU or WFUHS)

Are you or any person included in the H-1B application, an applicant for an immigrant visa or adjustment of status to permanent residence?
Yes No

   
If "Yes," please provide a brief description of the circumstances surrounding the immigrant petition (i.e. type of petition, date it was filed, employer-based or self-petition, etc.):
 

Have you or any person listed in the H-1B application ever done anything that violated the terms of the nonimmigrant status you presently hold?
Yes No

If you currently hold H-1B status with another employer, please answer the following questions:
   
Please provide the date on which you were first granted H-1B status or entered the U.S. in H-1B status:
Year
 

Please provide the the petition receipt number from your last H-1B approval notice:
(e.g. ABC-01-234-56789)
 
What is the expiration date of your current H-1B status:
Year
   

If you are not currently classified as an H-1B1 nonimmigrant, have you ever held this classification in the past?
Yes No

   
If "Yes," please list the beginning and end date(s) of your H-1B1 status period(s) as depicted on the H-1B approval notice(s):
From To
From To
From To
From To

If you are currently residing in the U.S. in J-1/J-2 status or have ever held this status in the past, please answer the following questions:
   

Are you subject or have you ever been subject to the two-year home residency requirement (212(e))?
Yes No
   

Have you fulfulled or been granted a waiver of the requirement from the Department of State?
Yes No

If you are currently employed in the U.S. in H-1B status by an employer other than WFU, please answer the following:
 
Name of your current employer:
 

Type of employer (i.e. non-profit, university, governmental agency, private industry, etc.):
 
Official job title:
 

If you are no longer employed with this employer or any other employer, please give the date when your last period of employment ended:
Year

Please provide a brief description/summary of the duties associated with your job at WFU:
 
If you will be applying for an H-1 visa outside of the U.S., please provide the location of the U.S. Embassy/Consulate where you will be scheduling your visa interview:
 
Additional comments:


H-1 Document Checklists

All documentaiton and filing fees that will need to accompany the H-1 petition are outlined in the various checklists below. Only copies of original documents should be submitted. All documents and fees should be submitted to Mr. Kent Greer of the Reynolda Campus Center for International Studies. If you are unsure as to which checklist best applies to your individual situation, please contact Mr. Greer.

Any questions pertaining to the H-1B application process should be addressed to Kent Greer in the Wake Forest Center for International Studies.

Kent Greer
P.O. Box 7385
Winston-Salem, NC 27109

e-mail: greerrk@wfu.edu
Tel: (336) 758-6033