Teachers Council - Educational Leadership in America

 


Visa Transfer Extension Application Form

  • * Required Field
   If you have taught or are currently teaching in the U.S., please complete:
  How did you hear about us? * Internet Search
Referral, please indicate the name:
Other, please specify:
Personal Information  
  First Name*
  Last Name*
  Full Middle Name
  Provide Any other names (in Full Name) used legally (1st Other Name)
(2nd Other Name)
(3rd Other Name)
  Gender*
  Date of Birth* (MM/DD/YYYY)
  Marital Status *
  Social Security Number
  USCIS Alien Number [if any. If none, enter “(none)”]
  Home Phone*
  Cell Phone
  Email*
  Street Name and Number*
  City*
  State*
  Zip Code*
  Home Country*
  Province where you were born?
  Address at Home Country  
  Street Name and Number *
  City or Town *
  Province *
  Postal Code *
Education
 
Do you have a Master’s or higher degree from a U.S. college or university?
  If Yes, please provide – Name of College/University
  Address of the College/University
  Type of Degree (ex. Master of Education, Master of Arts)
  Major
  Date Degree Awarded
  Do you have a Master’s or higher degree from a foreign institute?
  Highest Degree Awarded
Enter only the highest-level degree information.
IF you have provided an U.S. Master’s or higher degree information above, please skip to “Current School” section.
  Degree*
  School Name*
  Major*
  From* (MM/DD/YYYY)
  To* (MM/DD/YYYY)
  School Location*
Petitioning Employer(H-1B Visa)
  Corporate/School Name
  Federal Employer ID #
  Employer Address - Street Name and Number
  City
  State
  Zip Code
  Official Phone #
  Signing Official
  Title
  The Official's Email Address
  Date of Incorporation (MM/DD/YYYY)
  Nature of Business
  Number of Employees
  Job Title of Position Offered
  Teaching Subject / Area
  Work Location (Full Address)
  Start Date of New or Extended Visa Status (MM/DD/YYYY)
  Note: Enter the earlier date between:
(a) The first day of your new/extended H1B employment as offered by your employer; or
(b) The expiration date of your current nonimmigrant status.
  End Date of New or Extended Visa Status (MM/DD/YYYY)
  Note: Enter the earliest date among the following three dates:
(a) The last day of your new/extended H1B employment as offered by your employer;
(b) 1095 days (3 years) from the above Start Date; or
(c) The last day of the accumulated 6 years that you have actually stayed in the U.S. in H status for last 7 years. If you stayed overseas 1 year or more during the period, the accumulation counts only the period after you return to the U.S.
  Annual Salary Offered
Current School  
  IF your Current School is same as the above Petitioning Employer, skip to <Teaching Certificate> section.
  School Name
  Subject(s) Teaching/Taught
  School Address
  School State
Teaching Certificate  
  Teaching License 1*
  License1 Expiration Date* (MM/DD/YYYY)
  Teaching License 2
  License2 Expiration Date (MM/DD/YYYY)
Visa Status  
  General  
  Note: Everyone needs to fill out General information Plus:
J-1/J-2 to fill out Part A
F-1 to fill out Part B
  Current Visa Status*
  City Name where the U.S. Consulate located and issued your original visa
  Current Status Expiration Date*
(For F-1/F-2 and J-1/J-2 enter “D/S”) 		(MM/DD/YYYY, D/S)
  I-94 Number
  Last US Arrival Date (MM/DD/YYYY)
  If applicable, USCIS Case # for Previous H-1B Visa Petition
  If applicable, USCIS Case # for Other Immigration Application
  Passport Number
  Passport Issue Date (MM/DD/YYYY)
  Passport Expiration Date (MM/DD/YYYY)
  Employment/Sponsorship
  Transcript Evaluation
(If yes, name of evaluation company)
  Part A (J-1 Visa Holders. If you have a J-2 Visa, enter your spouse's information)
  J-1 Visa Status
  J-1 Program Expiration Date on Form DS-2019 Certificate (MM/DD/YYYY)
  No Objection Letter?
  Objection Letter Date (MM/DD/YYYY)
  USCIS Case Number
  DOS intent to provide waiver
  Date of DOS Letter (MM/DD/YYYY)
  Waiver Granted, Case Number
  Part B (F-1 Visa Holders)
  School Name
  I-20 Starting Date (MM/DD/YYYY)
  I-20 Expiration Date (MM/DD/YYYY)
  Graduate Date
  OPT Starting Date (MM/DD/YYYY)
  OPT Expiration Date (MM/DD/YYYY)
Processing Information  
  Is this an application for change of status?
  Is this an application for extension of status?
  If extension of status, are you continue working with the same employer?
  If extension of status, are you changing your employer?
  Have you or your family ever applied for a U.S. permanent residence application (“green card”)?
  If so, briefly explain
 
Provide each of your previous stays in H-1B, H-4, or other H status in the U.S. for past 6 years
  Arrival Date for 1st Stay in H Status: (MM/DD/YYYY)
  Departure Date for 1st Stay in H Status (MM/DD/YYYY)
  Arrival Date for 2nd Stay in H Status: (MM/DD/YYYY)
  Departure Date for 2nd Stay in H Status: (MM/DD/YYYY)
  Arrival Date for 3rd Stay in H Status: (MM/DD/YYYY)
  Departure Date for 3rd Stay in H Status: (MM/DD/YYYY)
 
  Are you apply with your family?
  If so, how many family members are applying?
 
If You Are Applying With Your Family Member
Please begin with Spouse information (if applicable) or the eldest Child information
Family Member 1  
  Family Name (Last Name)
  Given Name (First Name)
  Middle Name
  Relationship
  Date of Birth (MM/DD/YYYY)
  Current Visa Status
  Current Status Expiration Date (MM/DD/YYYY)
  I-94 Number
  Last Arrival Date (MM/DD/YYYY)
  SSN
  Passport Number
  Passport Issue Date (MM/DD/YYYY)
  Passport Expiration Date (MM/DD/YYYY)
  Has this person ever legally employed/worked in the U.S. since the last arrival?
  If NO, explain in 1-2 sentences about how you financially supported this person. Please include the name of your current employer organization, location of the employer, your job title, and the annual salary.
  If YES, explain the person’s employment, including the name and address of the employer organization, amount of weekly income, and the USCIS employment authorization card #, and the valid period.
   
Provide this family member’s previous stays in H-1B, H-4, or other H status in the U.S. for past 6 years.
[ If you are not H-4 visa holder, please skip this part ]
  Arrival Date for 1st Stay in H Status: (MM/DD/YYYY)
  Departure Date for 1st Stay in H Status (MM/DD/YYYY)
  Arrival Date for 2nd Stay in H Status: (MM/DD/YYYY)
  Departure Date for 2nd Stay in H Status: (MM/DD/YYYY)
  Arrival Date for 3rd Stay in H Status: (MM/DD/YYYY)
  Departure Date for 3rd Stay in H Status: (MM/DD/YYYY)
   
Family Member 2  
  Family Name (Last Name)
  Given Name (First Name)
  Middle Name
  Relationship
  Date of Birth (MM/DD/YYYY)
  Current Visa Status
  Current Status Expiration Date (MM/DD/YYYY)
  I-94 Number
  Last Arrival Date (MM/DD/YYYY)
  SSN
  Passport Number
  Passport Issue Date (MM/DD/YYYY)
  Passport Expiration Date (MM/DD/YYYY)
   
Provide each of your previous stays in H-1B, H-4, or other H status in the U.S. for past 6 years.
[ If you are not H-4 visa holder, please skip this part ]
  Arrival Date for 1st Stay in H Status: (MM/DD/YYYY)
  Departure Date for 1st Stay in H Status (MM/DD/YYYY)
  Arrival Date for 2nd Stay in H Status: (MM/DD/YYYY)
  Departure Date for 2nd Stay in H Status: (MM/DD/YYYY)
  Arrival Date for 3rd Stay in H Status: (MM/DD/YYYY)
  Departure Date for 3rd Stay in H Status: (MM/DD/YYYY)
   
Family Member 3  
  Family Name (Last Name)
  Given Name (First Name)
  Middle Name
  Relationship
  Date of Birth (MM/DD/YYYY)
  Current Visa Status
  Current Status Expiration Date (MM/DD/YYYY)
  I-94 Number
  Last Arrival Date (MM/DD/YYYY)
  SSN
  Passport Number
  PassPort Issue Date (MM/DD/YYYY)
  Passport Expiration Date (MM/DD/YYYY)
     
Provide this family member’s previous stays in H-1B, H-4, or other H status in the U.S. for past 6 years.
[ If you are not H-4 visa holder, please skip this part ]
  Arrival Date for 1st Stay in H Status: (MM/DD/YYYY)
  Departure Date for 1st Stay in H Status (MM/DD/YYYY)
  Arrival Date for 2nd Stay in H Status: (MM/DD/YYYY)
  Departure Date for 2nd Stay in H Status: (MM/DD/YYYY)
  Arrival Date for 3rd Stay in H Status: (MM/DD/YYYY)
  Departure Date for 3rd Stay in H Status: (MM/DD/YYYY)