United States: EB-1 Extraordinary Ability Questionnaire

EB-1 Extraordinary Ability Questionnaire

Please answer all questions that apply to you.

Part I – Contact Information

Current Job

Preferred address for receiving mail: office home other

Part II – Qualifications (Required Fields)

I have received the following award(s) or honor(s) from an employer association, university, etc.:

I am a member of professional association(s) that requires specific achievements or credentials to qualify for membership:

I have been quoted or my name has been mentioned in the following press (newspapers, magazines, industry publications, academic journals, televisions, etc.):

I have not been quoted or mentioned by name in the press, but I have been involved in projects or endeavors that have received media coverage. I can get copies of the article(s), and an authority in my field will attest to the significance of my work relative to the media coverage. Examples of this press coverage are as follows:

I have been asked to evaluate or judge (by myself or on a panel or team) the work of others in my field (e.g., an editorial review board, grant-giving advisory committee, professional association conference planning position, etc.):

My compensation is high in comparison to others in my field (include stock options and other forms of compensation). Last year's total gross compensation was (USD):

The following experts in the field (e.g., vice presidents or other officers, professors, etc.) at prestigious companies, universities, government agencies (U.S. or foreign) or other entities would probably be willing to sign supporting letters on my behalf. (Name at least three people – NO MORE THAN ONE PERSON PER ENTITY). Name at least one person from a company where you have never worked or a university where you have not matriculated.

I have been contacted by a "headhunter" or recruiter in recent years and I would be able to call this person to see if s/he can help establish my stature in the field.

My work is known to an official of a United States government agency and I believe a qualified employee of that agency would sign a letter on my behalf confirming that my current or proposed work is in the nation's interest.

Name of U.S. Government Agency:

United States interests served or improved (check all that apply):

U.S. Economy Affordable Housing

Job Creation Wages or working conditions for U.S. workers

Health Care Education for U.S. children or under-qualified workers

Environment Other:

Part III – Qualifications

(Optional Fields – May Include CV or Resume in lieu of Completing)

Please fill out the following fields only if you are not providing your resume/c.v. – OR – if your resume/c.v. does not fully reflect the information requested in Part III.

I have made significant original contributions in my field of endeavor. Briefly describe the contributions or achievements below and mention any patents, copyrights, etc. This is a mandatory qualification, so take time to describe it here if it's not reflected on your provided resume or C.V.:

I have published article(s), book(s), and/or paper(s) on topics related to my field:

I have played a leading or critical role for an organization, academic entity, public agency, committee, or distinguished company within my field:

If applicable – I have presented or exhibited my work in artistic exhibitions or showcases:

If applicable – my work has met with commercial success in the performing arts, as shown by box office receipts, or record/cassette/CD/video sales:

I have a diploma from the following universities (again, only fill this out if you're not attaching a resume or c.v.):

Job history. Last three positions (only fill out if you're not attaching your resume or c.v.):

There is other evidence not listed above which may help demonstrate my stature:

Part IV – Current U.S. Status and History

If you are currently in H-1B or L-1 status, how much time do you have left before having to get a green card or leave the U.S. for one year (e.g., H-1B maximum is 6 years)? Count only the times you have actually worked in H-1B or L-1 status, not your visa approval dates. Time Left: Months/Years

Have you ever been on a J-1 visa Yes No

If you answered Yes above, will a waiver of the 2-year foreign residency requirement be needed? Yes No. Explain:

Will you be seeking U.S. permanent residence for a spouse and/or children? If yes, please fill in their information.