The purpose of this questionnaire is to determine whether you
qualify for Permanent Residency under a provision of the law for Outstanding
Researchers and Professors. This provision applies only to those who have worked
for at least three years as a professor or researcher. Although some of the
information you will provide may be on your curriculum vitae already, and thus
may seem redundant, please be sure to include as much detail as possible.
Please print this form and write or type your answers into the right column
| GENERAL INFORMATION | |
| Full Name (with last name in caps): | |
| U.S. Address: |
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| Address in your home country:
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| Email Address: | |
| Mobile Telephone: | |
| Home Telephone: | |
| Office Telephone: | |
| Fax number: | |
| Social security number: | |
| Date of Birth: | |
| Place of Birth (City, Country): | |
| Country of Nationality: | |
| Employer's Name: | |
| Employer's Main Address: |
|
| Your Worksite Address, if
different: |
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| Employer's Main Telephone Number: | |
| INFORMATION REGARDING YOUR EMPLOYMENT | |
| Job title: | |
| Annual salary: | |
| Provide a detailed job
description including specific responsibilities, with emphasis on your
research and development duties: |
|
| Requirements for this position (include educational requirements, specific skills, experience, and expertise required): | |
| Provide information about the importance of your work/research and how it will benefit and impact the U.S: | |
| Provide information regarding the number of people you supervise, if any, and what type of employees they are (e.g., scientists, post docs, and technicians): | |
| Does your employer employ at least three persons full-time in research positions? If yes, provide details: | |
| INFORMATION REGARDING YOUR QUALIFICATIONS | |
| State your academic or scientific field of expertise as precisely as possible: | |
| List the places you have worked as a researcher or professor for pay before joining your present employer, including any work for pay during your education: | |
| Describe any major discoveries
or innovations that have occurred as a result of your research and how
they contribute to your field. Be sure to include information about
pending and/or approved patents, if any: |
|
| Describe the nature of your research activities prior to your current employment: | |
| List all major prizes or awards you have received for your research, if any, and describe the significance of each award: | |
| Are you a member of any associations that require outstanding achievements from its members? If so, provide details about the criteria for selection (do not list associations with open membership): | |
| Have you ever participated as a judge of the work of others in your field (i.e., conducting peer review for academic journals, sitting on award-giving panels, or supervising graduate students). If so, please provide details: | |
| Have you presented papers or served as a program committee member at major international conferences in the field? If so, provide details: | |
| Have others written about your work in professional publications. If so, please cite all sources: | |
| Has any of your publications been cited in peer-reviewed journal articles? If so, provide a list of these publications, including title, date, author and source. Please also make photocopies of these publications, including the title page, citation page and bibliography. | |
| List all scholarly articles, books, or chapters in books that you have written, if any: Also, provide photocopies of all of your articles. | |
| Are there other ways in which your research has been internationally recognized as outstanding? | |
| Spouse | |
| Name: | |
| Address: |
|
| Date & Place of Birth: |
|
| Child #1 | |
| Name: | |
| Address: |
|
| Date & Place of Birth: |
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| Child #2 | |
| Name: | |
| Address: |
|
| Date & Place of Birth: |
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| Child #3 | |
| Name: | |
| Address: |
|
| Date & Place of Birth: |
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Required evidence to prove
your eligibility as an Outstanding Researcher or Professor - provide as
much of the below documentation as you can (you must have at least
two of the following):
Additional Required Documents - please mail the following documents along with the completed questionnaire to us:
Although the list of documents above may appear onerous, it is important to be thorough because the more complete you are with the document gathering process, the better we can prepare your case. After you submit the necessary information and documents to Immigration Law Group, we will write a detailed statement to support the permanent residency petition, and email a draft of this statement to you for review before all of the documents are finalized for filing with the BCIS. Immigration Law Group LLP 2880 Zanker Road, Suite 201 San Jose, CA 95134 Tel (408) 432-9200 Fax (408) 432-9191 |
| Please answer the following
questions. (If your answer is "YES" on any one of these questions,
explain on a separate piece of paper. a. Have you ever, in or outside the U.S.:
___ Yes __ No b. Have you received public assistance in the U.S. from any source, including the U.S. government or any state, county, city, or municipality (other than emergency medical treatment), or are you likely to receive public assistance in the future? ___ Yes __ No c. Have you ever:
___ Yes __ No d. Have you ever engaged in, conspired to engage in, or do you intend to engage in, or have you ever solicited membership or funds for, or have you through any means ever assisted or provided any type of material support to, any person or organization that has ever engaged or conspired to engage, in sabotage, kidnapping, political assassination, hijacking, or any other form of terrorist activity? ___ Yes __ No e. Do you intend to engage in the U.S. in:
___ Yes __ No f. Have you ever been a member of, or in any way affiliated with, the Communist Party or any other totalitarian party? ___ Yes __ No g. Did you, during the period March 23, 1933 to May 8, 1945, in association with either the Nazi Government of Germany or any organization or government associated or allied with the Nazi Government of Germany, ever order, incite, assist or otherwise participate in the persecution of any person because of race, religion, nationality, ethnic origin, or political opinion? ___ Yes __ No h. Have you ever engaged in genocide, or otherwise ordered, incited, assisted or otherwise participated in the killing of any person because of race, religion, nationality, ethnic origin, or political opinion? ___ Yes __ No i. Have you ever been deported from the U.S., or removed from the U.S. at government expense, excluded within the past year, or are you now in exclusion or deportation proceedings? ___ Yes __ No j. Are you under a final order of civil penalty of violating section 274C of the Immigration Act for use of fraudulent documents, or have you by fraud or willful misrepresentation of a material fact, ever sought to procure, or procured, a visa, other documentation, entry into the U.S., or any other immigration benefit? ___ Yes __ No k. Have you ever left the U.S. to avoid being drafted into the U.S. Armed Forces? ___ Yes __ No l. Have you ever been a J non-immigrant exchange visitor who was subject to the 2 year foreign residence requirement and not yet complied with that requirement or obtained a waiver? ___ Yes __ No m. Are you now withholding custody of a U.S. Citizen child outside the U.S. from a person granted custody of the child? ___ Yes __ No n. Do you plan to practice polygamy in the U.S.? ___ Yes __ No |