Office of International Affairs
Biodata Information Form
H-1B
Section I: Visitor Information
______________________
_____________________
___________________
LAST/FAMILY NAME
First/Given Name
Middle
_________________________________________________________________________
Date of Birth (MM/DD/YYYY)
Email Address
_________________________________________________________________________
U.S. Residential Address: Street
Apartment #
City
State
Zip Code
_________________________________________________________________________
Telephone Number: Home
Cell
Work
Fax
Gender:
Male
Marital Status:
Single
Married
Female
Other, please indicate:______________________________
______________________
_____________________
___________________
City of Birth
Country of Birth
Country of Citizenship
Permanent Address in Home Country:
______________________________________________
Home or Apartment # and Street
_____________________
___________________
City
State/Province
_____________________
___________________
Country
Postal Code
Section II: Immigration Information
U.S. Entry Information:
Are you currently in the U.S.?
Yes
No
________________________________________
If yes, please indicate your current immigration status:
__________________________________
If yes, please provide the 11-digit number on your Form I-94:
Passport Information:
Do you have a passport valid 6 months into the future?
Yes
No
If yes, please provide the information below:
________________________________________________
Name (as it appears on the passport)
_______________________ ________________________
Country of Issuance
Date of Expiration
_________________________________________________________________________
Phone: 713-500-3176
Fax: 713-500-3189
E-mail: utoiahouston@uth.tmc.edu
7000 Fannin Street, Suite 130
Houston, TX 77030
Web: