Form H-1b - Request Form - Part A Page 3
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C. ADMINISTRATIVE CONTACT INFORMATION
Name: ____________________________________________ Title: _________________________________
Phone: ___________________
Fax: ___________________
E-mail: __________________
Address: ________________________________________________________________________________________
Street
City
State
Zip Code
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D. PRINCIPAL INVESTIGATOR CONTACT INFORMATION
Name: ____________________________________________ Title: _________________________________
Phone: ___________________
Fax: ___________________
E-mail: __________________
Address: _______________________________________________________________________________________
Street
City
State
Zip Code
Office of International Students and Scholars
Wayne State University
42 W. Warren, Suite 416 ◊ Detroit, Michigan 48202 ◊ (313) 577-3422 ◊ FAX (313) 577-2962 ◊ OISSscholars@wayne.edu
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