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H-2B APPLICATION

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DOCUMENTE SIMILARE

Trimite pe Messenger
CLASSIFICATIONS OF LAW
H-2B APPLICATION

Do not write – official use only



 

attach your photo here

 
H-2B

2005

APPLICATION

Personal Information                        

Family Name . . . . . . . . . . . . . . . . . . . . . . . . First Name . . . . . . . . . . . . . . . . . . . Middle . . . . . . . . . . . . . . .

Present Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

City/ Country/ Postal Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Telephone . . . . . . . . . . . . . . . Fix . . . . . . . . . . . . . . . E-mail . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Permanent Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

City/ Country/ Postal Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Telephone . . . . . . . . . . . . . . . Fix . . . . . . . . . . . . . . .

What is your passport number . . . . . . . . . . . . . . . . . Country . . .  . . . . . . . . . . . . Expires . . . . . . . . . . . . . .

Emergency Contact

Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . . . . . Telephone . . . . . . . . . . . . . . . . . . . . . .

City/ Country/ Postal Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Speaks English No [   ] Yes [   ]                Relation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . . . . . . . . . .

Tell us about yourself

Age . . . . . .  Date Born (month/ day/ year) . . . . . . . . . . . . . . . . . . City of birth . . . . . . . . . . . . . . . . . . . . . .

Citizen of . . . . . . . . . . . . . . . . . . . . . . Country of Birth . . . . . . . . . . . . . . . . . . . . . .

Male [   ]   Female [   ]                         Married [   ]   Single [   ]   Other [   ]

Your Height. . . . .cm                                                    Your Weight . . . . .Kg

Have you ever served in the army forces? No [   ] Yes [   ] If yes branch. . . . . Dates: from. . . . .to. . . . . . .

Do you smoke? No [   ] Yes [   ]                Do you have driver’s license (categories)? . . . . . . . . . . . . . . . . .

Tell us about your education

Circle the highest grade completed:  High school 1  2  3  4   University   1  2  3  4  5   6 Others. . . . . . . . . .

Name and address of the last school  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

How many years of English Language?          High school . . . . . . . . University . . . . . . . . .

Have you taken TOEFL / FCE Test? No [   ] Yes [   ]            If yes, score: . . . . . . . . . .    year: . . . . . . . .

Other Languages spoken . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Hobbies and interests. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Tell us about your travels

Have you ever applied for a program before? No [   ] Yes [   ] When? . . . . . . . . . . . . . .

With which organization? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Were you accepted No [   ] Yes [   ]

Have you been to the USA before? No [   ] Yes [   ] If yes, when and where?. . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Please turn the page




 


Tell us about your previous work or training experience

1. Last employer . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Telephone . . . . . . . . . . . . . . . . . . . . . .

City/ Country/ Postal code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of immediate supervisor . . . . . . . . . . . . . . . . . . . . . .

Dates of employment: from . . . . . . . . . . . . . . . . . . . . . . . . . . . to. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2. Previous employer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Telephone . . . . . . . . . . . . . . . . . . . . . .

City/ Country/ Postal code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of immediate supervisor . . . . . . . . . . . . . . . . . . . . . .

Dates of employment: from . . . . . . . . . . . . . . . . . . . . . . . . . . . to. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. Previous employer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Telephone . . . . . . . . . . . . . . . . . . . . . .

City/ Country/ Postal code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of immediate supervisor . . . . . . . . . . . . . . . . . . . . . .

Dates of employment: from . . . . . . . . . . . . . . . . . . . . . . . . . . . to. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Tell us about your expectations:
Why should we accept your application: ……………………………………………………………………

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What do you expect from this job: …………………………………………………………………………..

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Other skills that relate you to this job: ………………………………………………………………………

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Tell us about your health:

Do you have any allergies or health problems that will affect your ability to work? . . . . . . . . . . . . . . . . . . . 

Have you had any health problems or Surgeries in the past? No [  ] Yes [   ]. . . . . . . . . . . . . . . . . . . . . . . . .  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

TO BE READ AND SIGNED BY THE APPLICANT

IT IS AGREED AND UNDERSTOOD THAT ANY MISREPRESENTATION OF INFORMATION GIVEN ABOVE AND WITHIN SHALL BE CONSIDERED AN ACT OF DISHONESTY.

IT IS AGREED AND UNDERSTOOD THE EMPLOYER OR ITS AGENTS MAY INVESTIGATE THE APPLICANT’S BACKGROUND TO ASCERTAIN ANY AND ALL INFORMATION OF CONCERN TO APPLICANT’S RECORD, WHETHER SAME IS RECORD OR NOT, AND APPLICANT RELEASES EMPLOYERS AND PERSONS NAMED HEREIN FROM ALL LIABILITY FOR DAMAGES ON ACCOUNT OF THEM FURNISHING SUCH INFORMATION.

IT IS AGREED AND UNDERSTOOD THAT THIS APPLICATION IN NO WAY OBLIGATES THE EMPLOYER TO EMPLOY THE APPLICANT.

IT IS AGREED AND UNDERSTOOD THAT IF HIRED, THE EMPLOYEE WILL BE ON A SIXTY (60) DAY EVALUATION PERIOD.

IT IS AGREED AND UNDERSTOOD THAT ALL EMPLOYMENT WITH THE COMPANY IS ON AN AT-WILL BASIS AND AS SUCH THE COMPANY MAY TERMINATE EMPLOYMENT AT ANY TIME AND FOR ANY REASON.

THIS CERTIFIES THAT THIS APPLICATION WAS COMPLETED BY ME AND THAT ALL ENTRIES ON IT AND INFORMATION IN IT ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

                                                        .                                       ________________________________

APPLICANT’S SIGNATURE                               DATE                                 








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