High Skilled Immigration - Goel & Anderson

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High-Skilled Immigration Intake Questionnaire

Case Number

BIOGRAPHIC INFORMATION

Last Name

First Name

Email Address

Gender

MaleFemale

Date of Birth

mm/dd/yyyy

City/Town/Village of Birth

State or Province of Birth

Country of Birth

Country of Citizenship

Marital Status

Do you have any children?

Yes

Passport Number

Expiration Date

mm/dd/yyyy Note: Must be valid on the date of filing

Country of Issuance

U.S. Social Security Number (if any)

9 digits (no dashes, no spaces)

Alien Number (if any)

9 digits (no dashes or spaces)

RESIDENTIAL & CONTACT INFORMATION

Do you currently live and work outside the United States?

YesNo

U.S. ADDRESS

Street Name and Number

Apartment No

City

State

Zip Code

U.S. Home Phone

10 Digits (no spaces no dashes)

U.S. Work Phone

10 Digits (no spaces no dashes)

FOREIGN ADDRESS

Street Name and Number

Apartment No.

City

State/Province

Zip/Pin Code

Country

Foreign Home Phone

15 Digits (no spaces no dashes)

Foreign Work Phone

15 Digits (no spaces no dashes)

Are you currently in the United States?

YesNo

Page 2

U.S. IMMIGRATION INFORMATION

Date of Last Arrival

mm/dd/yyyy Note: Must be valid on the date of filing

Place of Last Entry (City/State)

I-94 Number

11 digits (include leading zero, if applicable)

I-94 Expiration Date

mm/dd/yyyy: Leave blank if outside U.S.

Visa Used for Entry

Leave blank if outside U.S.

Current Status

Leave blank if outside U.S.

Place Visa Issued (City/State)

U.S. VISA/TRAVEL HISTORY

Please list all prior periods of travel to the United States. List dates in chronological order beginning with your most recent arrival. Click "Add Another" to continue recording your travel dates. If you are present in the U.S. today, leave the first "U.S. Departure" field blank.

Date of Entry

Date of Departure

Visa Type

Have you ever been refused admission at a U.S. Port of Entry?

Yes

If yes, please explain

Have you ever been refused a visa?

Yes

If yes, where and when (mm/dd/yyyy) did you apply for the visa?

Has your U.S. visa ever been cancelled or revoked?

Yes

If yes, please explain (consulate information, date, reason):

Has anyone ever filed an immigrant visa petition for you?

Yes

If yes, who (brother, mother, employer, etc.)?

Petition Type

EDUCATION

Name of College/University

Address of University (Street Name and Number)

City

State/Province

Zip/Pin Code

Country

Degree Awarded

Field of Study/Major

e.g., Mechanical Engineering, Computer Science

Month Completed

Year Completed

yyyy

Add Another Education?

YesNo

EDUCATION 2

Name of College/University

Address of University (Street Name and Number)

City

State/Province

Zip/Pin Code

Country

Degree Awarded

Field of Study/Major

e.g., Mechanical Engineering, Computer Science

Month Completed

Year Completed

yyyy

Add Another Education?

YesNo

EDUCATION 3

Name of College/University

Address of University (Street Name and Number)

City

State/Province

Zip/Pin Code

Country

Degree Awarded

Field of Study/Major

e.g., Mechanical Engineering, Computer Science

Month Completed

Year Completed

yyyy

EMPLOYMENT

Important Tips:

Enter your jobs in reverse chronological order (newest to oldest).
Do NOT use bullet or numbered lists.
Do NOT use ALL CAPS.
If you have worked for an employer both inside the U.S. and outside the U.S., list the U.S. employment separate from the employment outside the U.S.

I have read this section

As you complete the Job Duties fields, please refrain from using "System (ANY TEXT)" language.

Current Employer

Current Employer

If your Employer's business name has changed recently, record the new name.

Address 1

Address 2

City

State/Province

Zip

Occupation/Job Title

List your internal designation, not your project role.

Current Annual Salary

Annual Base Salary (not including incentives, bonuses, etc.)

Hours (per week)

Employed in Current Position Since

Please provide the date in month, day, year format only

Employment History

Previous Employer Name

Address 1

Address 2

City

State/Province

Zip

Country

Occupation/Job Title

List your internal designation, not your project role.

Employed From

Please provide the date in month, day, year format only

Employed To

Please provide the date in month, day, year format only

Hours (per week)

Page 3

Dependents Information

SPOUSE'S BIOGRAPHIC DATA

Spouse's Last Name/Surname

Spouse's Given Name(s)

Date of Birth

mm/dd/yyyy

Country of Birth

Is he or she applying for adjustment of status?

Yes

CHILD BIOGRAPHIC DATA

Child's Last Name/Surname

Child's Given Name(s)

Date of Birth

mm/dd/yyyy

Country of Birth

Is he or she applying for adjustment of status?

Yes

Page 4

ADDITIONAL QUESTIONS

Have you ever been issued a Notice to Appear (NTA)?

Yes

Have you ever been the subject of an exclusion, deportation, or removal proceeding?

Yes

Have you ever been denied any immigrant benefit?

Yes

Have you ever been a J-1 Exchange Visitor or J-2 Dependent?

Yes

Have you ever committed a crime of any kind?

Yes

Have you ever been arrested, cited, charged, or detained for any reason by any law enforcement official?

Yes

Have you ever lied about, concealed, or misrepresented any information on an application or petition to obtain a visa, other documentation required for entry into the United States, admission to the United States, or any other kind of immigration benefit?

Yes

If you answered “Yes” to any of the above, please provide an explanation in this space:

Page 5

Legal Criteria for EB-1A/B and/or EB-2 National Interest Waiver

"Extraordinary ability means a level of expertise indicating that the individual is one of that small percentage who have risen to the very top of the field of endeavor."

An employment-based immigration petition based on extraordinary ability must be accompanied by evidence that the alien has sustained national or international acclaim and that his or her achievements have been recognized in the field of expertise. Such evidence shall include evidence of a one-time achievement (that is, a major, international recognized award), or at least three of the following:

Documentation of the alien's receipt of lesser nationally or internationally recognized prizes or awards for excellence in the field of endeavor;
Documentation of the alien's membership in associations in the field for which classification is sought, which require outstanding achievements of their members, as judged by recognized national or international experts in their disciplines or fields;
Published material about the alien in professional or major trade publications or other major media, relating to the alien's work in the field for which classification is sought. Such evidence shall include the title, date, and author of the material, and any necessary translation;
Evidence of the alien's participation, either individually or on a panel, as a judge of the work of others in the same or an allied field of specification for which classification is sought;
Evidence of the alien's original scientific, scholarly, artistic, athletic, or business-related contributions of major significance in the field;
Evidence of the alien's authorship of scholarly articles in the field, in professional or major trade publications or other major media;
Evidence of the display of the alien's work in the field at artistic exhibitions or showcases;
Evidence that the alien has performed in a leading or critical role for organizations or establishments that have a distinguished reputation;
Evidence that the alien has commanded a high salary or other significantly high remuneration for services, in relation to others in the field; or
Evidence of commercial successes in the performing arts, as shown by box office receipts or record, cassette, compact disk, or video sales.

The director may exempt the requirement of a job offer, and thus of a labor certification, for aliens of exceptional ability in the sciences, arts, or business if exemption would be in the national interest.

As a matter of discretion, USCIS may grant a national interest waiver based on the following three prongs:

The person's proposed endeavor has both substantial merit and national importance;
The person is well positioned to advance the proposed endeavor; and
On balance, it would be beneficial to the United States to waive the job offer and thus the permanent labor certification requirements.

Page 6

Please provide the information requested below

Name of the employer that you will be working for if your green card is approved.

Would your employer be willing to sponsor you for a green card?

Yes

Describe your area of expertise. Please be as specific as possible.

Explain in detail your field of expertise.

In detail, please explain how your work is unique and original, how it addresses the currently existing problems, and how your research/approach is a better alternative.

Explain how your work would translate to potential significant economic impact or substantially improve area including, but not limited to, business, entrepreneurship, science, technology, culture, health, or education.

Explain how your work is of national (or global) importance.

Explain how you are well positioned to advance the proposed endeavor.

Explain how your work in your field of expertise would be beneficial to the United States.

In detail, please provide a model or plan for future activities and details of any progress towards achieving the proposed endeavors.

Page 7

Degree/Certifications

List any degrees or professional certifications that demonstrate recognition or standing in your field. You do not need to repeat your full education history. Only include items you consider evidence of professional distinction.

Have you ever been awarded any professional degrees or certifications in your field?

Yes

Degree/Certification Name

Issuing Institution

Date Received

Research Projects (Principal/Co-Principal Investigator)

Have you ever been a principal investigator or co-principal investigator on any research projects?

Yes

Project Title

Role (Principal Investigator / Co-Principal Investigator)

Institution/Organization

Start Date

End Date (leave blank if project is still ongoing)

Publications

Has your work ever been published in any professional journals or publications

Yes

Publication / Journal Title

Publisher of the Journal

Date Published

Citations of Your Work

This refers to instances where others cited your work, not your own publications.

Have you, or your research, ever been cited in any professional journals or publications?

Yes

Citing Author(s)

Citing Publication/Journal

Date

Please provide details.

Media Coverage & Published Profiles

This refers to media coverage or articles about you, not your own publications or citations of your work.

Have you ever been featured or mentioned in any professional or major trade publications or media?

Yes

Publication/Outlet Name

Title of Article/Feature

Date

Author (if known)

Speaking Engagements

Have you ever been invited to speak at any professional conferences or events?

Yes

Event/Conference Name

Topic

Date

Location

Patents, Trademarks, Grants

Have you ever been awarded any patents, trademarks, or research grants?

Yes

Type (Patent / Trademark / Grant)

Title/Number

Issuing Body

Date

Professional Recognition & Awards

Have you ever been recognized by any professional organizations or societies?

Yes

Award/Recognition Name

Issuing Organization

Date

Selection Criteria (explain)

Leadership Roles

Have you ever held any leadership roles in your profession or organization?

Yes

Role/Title

Organization

Start Date

End Date

Description of Responsibilities

Page 8

Additional/Supporting Evidence

If applicable, explain/state the following:

Do you have documentation reflecting feasible plans for financial support (generally applicable for entrepreneurs)?

Yes

Please explain.

Have you received investment from U.S. investors, such as venture capital firms, angel investors, or start-up accelerators, and that the amounts are appropriate to the relevant endeavor?

Yes

Please explain.

Do you have copies of contracts, agreements, or licenses showing the potential impact of your proposed endeavor?

Yes

Please explain.

Do you have letters from government agencies or quasi-governmental entities in the United States demonstrating that the person is well positioned to advance the proposed endeavor?

Yes

Do you have evidence that the person has received awards or grants or other indications of relevant non-monetary support (for example, using facilities free of charge) from federal, state, or local government entities with expertise in economic development, research and development, or job creation?

Yes

Please explain.

Do the following apply to you? (Select all that apply)

Contracts with companies using products that the person developed or assisted in developing.Documents showing technology that the person invented or contributed to inventing, and how others use that technology.Patents or licenses for innovations the person developed with documentation showing why the patent or license is significant to the field.

Have you ever been awarded any lesser nationally or internationally recognized prizes or awards for excellence in the field of endeavor?

Yes

Please provide details.

Are you a member in an association that require outstanding achievements in your field?

Yes

Please provide details.

Page 9

Distinguished Research Articles/Projects

If applicable, provide a list of research articles/projects where you have distinguished yourself.

Research Article/Project

Detailed Description of the Article/Project

Goal of the Article/Project

How the Research Was Conducted

Why the Research Is Important to the Field

Why the Research Was Particularly Challenging

How You Overcame the Challenge

Result

How the Research Was Recognized

Your Role in the Article/Project

Page 10

Please provide the following details regarding potential references.

Reference

Name

Job Title

Organization

Have you ever worked/collaborated with this reference source?

Yes

Please explain briefly.

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