NOTE: For either a change or an extension of current status, your dependent spouse in the US must complete Form I-539
and pay the USCIS fee. Dependent children born outside the US will be listed on the attachment page of your spouse’s Form
I-539. MUSC will mail your spouse’s petition and fee along with our H-1B petition.
VERY IMPORTANT:
If you (and your dependents, if any) have held any H status (H-1B and/or H-4) within the previous six years, provide
the dates of each person’s H status and specify which status was held. Provide only those periods when you and your
dependents were actually inside the US. Use an additional sheet of paper if necessary.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
If you have been in H-1B status with in the past 6 years, have you been outside the US for more than one year after attaining
the status? ___________________________________________________________________________________________
Are you in removal proceedings with the US Immigration and Customs Enforcement? ______________________________
If you have been in H-1B status in the last 6 years, provide the employer’s name and exact dates where previous H-1B was
held. You must provide a copy of each Form I-797 Approval Notice.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Have you ever been denied H-1B status inside the US? _______________________________________________________
Have you ever been denied an H-1B visa by a US Consulate or US Embassy? _____________________________________
Have you filed a petition for Lawful Permanent Resident status (aka Green card) in the US? __________________________
If yes, provide copy of Form I-797 Receipt Notice for your Form I-140 and/or Form I-485 or, a copy of any Form I-797
Approval Notices you have received for your green card petition.
If you are currently inside the US, provide the date of your last arrival to the US: ___________________________________
List the current non-immigrant status as reflected on Form I-94 Arrival/Departure record: ____________________________
Your non-immigrant status expires on ____________________________________ (as reflected on your current Form I-94)
The section below must be completed in addition to the Curriculum Vitae you must submit.
Highest Academic Degree which qualifies you to work at MUSC _______________________________________________
Date Diploma was Awarded ________________________
Major Field of Study for this degree _____________________
Was your degree earned from a US educational institution? ____________________________________________________