Date: Wed, 31 Dec 1997 21:15:08 GMT Server: WebSitePro/1.1h Accept-ranges: bytes Content-type: text/html Last-modified: Tue, 30 Sep 1997 17:36:48 GMT Content-length: 7426
If you would like us to open a file for you, please complete the following steps.
Name (Last, First, Middle):
Other names previously used (Last, First, Middle):
U.S. Alien Registration Number (if any): A
Residence Addresses and length of residences for the past five years:
Telephone number (Area code and number):
Facsimile number (Area code and number):
E-mail:
Date of Birth (Month, Day, Year):
Place of Birth (City and Country):
Current U.S. visa status (if any):
Date of visa expiration:
Date of last entry into the U.S.:
I-94 Card Number and Expiration Date:
Name of spouse (Last, First, Middle):
Spouse's Date of Birth (Month, Day, Year):
Spouse's Place of Birth (City and Country):
Name(s) of Children:
Date(s) of Child(ren)'s Birth:
Child(ren)'s Place(s) of Birth (City and Country):
Child(ren)'s National Citizenship or Current U.S. Immigration Status:
Your Occupation:
Your Current Job Duties:
Your Employer's Name and Address:
Your Employer(s) and length of time of each employment for last five (5) years, plus job duties or job description:
Your Spouse's Occupation:
Your Spouse's Current Job Duties:
Your Spouse's Employer's Name and Address:
Your Spouse's Employer(s) and length of time of each employment for last five (5) years, plus job duties or job description:
All education pursued or achieved by you from the age of 18 to the present:
All education pursued or achieved by your spouse from the age of 18 to the present:
Your U.S. Immigration Objectives:
Special education or job skills you now have:
Special expertise or knowledge you believe you can contribute to the U.S. economy:
Why do you want to work, reside or study in the U.S. or travel to the U.S.?
Please explain in detail all problems (if any) you have ever had with the U.S. Immigration Service, U.S. Customs Officials, any Executive Office for Immigration Review Court or Judge or any overseas U.S. Embassy or Consulate.
Please complete the above questionnaire and click the submission button below to email the form to our office. You can also complete and mail to the below address your answers to the above questions, a resume or curriculum vitae, any proof of present or past education and employment, copies of all previously submitted or received INS or U.S. Consulate documents, notices and visas.
Thank you for taking the time to complete this form.
OR
Copyright © 1997 Bruce W. Burns, Attorney at Law. All rights reserved.