Personal Information

Full Name (as in passport):

Date of Birth:

Country of Birth:

Country of Birth

Country of Citizenship:

Current City & Country:

Phone Number (WhatsApp): *

Email Address: *

Do you have a valid passport? *

Yes

No

Expired

Immigration History

Have you ever applied for a U.S. visa? *

Yes

No

If yes, which type(s)?

Have you ever been denied a U.S. visa? *

Yes

No

If yes, provide details:

Have you ever lived in the United States? *

Yes

No

If yes, what status?

Eligibility & Background

Are you willing to relocate to the U.S. for full-time work? *

Yes

No

Do you have any criminal history? *

Yes

No

If yes, explain:

Do you have any medical conditions that may prevent physical work? *

Yes

No

Are you able to perform physically active roles (standing, lifting, repetitive tasks)? *

Yes

No

Eligibility & Background

Marital Status: *

Single

Married

Divorced

Do you have children under 21 *

Yes

No

If yes, how many?

Do you want your spouse/children included in your EB-3 case? *

Yes

No

Work Preferences

Select the job categories you are interested in: *

Housekeeping / Hospitality

Warehouse / Logistics

Manufacturing / Production

Food Processing

Cleaning / Janitorial

Transportation Support

Any Available Job

Earliest date you can start:

English level: *

None

Basic

Intermediate

Advanced

Document Uploads

Upload Passport *

Upload any prior U.S. visa documents

Upload resume

Declaration *

I confirm that the information provided is true and complete.

I understand this form is for screening only and does not guarantee sponsorship.

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