Format:

You are encouraged to electronically fill out this info sheet and email it as an attachment to a Z&A attorney.

Alternatively, you may fill out a hard copy and mail or fax it to attorney at the corresponding address listed above.

Documents

• Job posting documents: journal, newspaper, online print out
• Selection Report and decision approved by the authority of the University
• Interview and selection records
• Offer letter to the alien
• Reasons why the alien is more qualified than other candidates – please state in detail

Total number of applications:    ____________________________________

Total number of interviewed candidates:    ___________________________

I. Information about Employer

Name:    _______________________________________________

Business Address:    _________________________________________________

Address where Alien will work (if different):    _______________________________

Telephone Number:    ________________________

Fax:    _____________________________

The Year Company established:    _________________

Number of Employees:    _______________________

Annual Gross Income:    _________________________

Annual Net Income:    _________________________

Nature of business activity:    _____________________________________

Signing Officer Info:

   Print of Name:    __________________________  Title:    __________________

II. Information about Job Offered

1. Name of job title:    ____________________________________

2. Total hours per week:    ________________________________

3. Work schedule of a working day (hourly):    ______________________________

4. Basic annual salary:    ____________________    overtime hourly salary:    ________________

5. Occupational title of Alien’s immediate supervisor:    _________________________

6. Number of employees Alien will supervise:    _______________________________

7. Description of job duties in details:    _______________________________

Minimum requirements

College degree required:    _______________    Degree Level:    __________________

Field of study:    ________________

Formal vocational training required:    _________________________ (year/month)

Type of training:    ___________________________________

Experience:    _________________________ (year/month)

Documentation about the Employer’s Recruiting Efforts:

At least one nationwide professional journal posting (paper version, not online version) is required. 

Media Name	Nature	Date of Posting
1. ___________	__________________	________________
2. ___________	__________________	________________
3. ___________	__________________	________________

III. Information about Alien Employee

Please fill out in detail though you may have submitted your Resume

Last Name:    ______________       First Name:    _________________ Middle Name:    ______

• Present Address:    ______________________________________
• Type of Visa:    ____________________
• Date of Birth:    ____________________
• Place of Birth:    __________________    (city)         ___________________ (country)
• Present Citizenship:    ______________________
• Home Address (if different from 2):    ___________________________________________________________________
• Name and Address of Employer:    _________________________________
• Proposed Title of Occupation:    ____________________________
• Alien’s Educational Background

Names and Street Addresses of Colleges	Field of Study	From month/year	To month/year	Degree

• Work Experience

(must include any experience for the past 3 years; and all other related experience for more than 3 years)

• Name and Street Address of Employer:

______________________________________________________

Name of Job:    _____________________________________

Date Started (mm/dd/yyyy):   ____________   Date Left (mm/dd/yyyy):   ____________

Kind of Business:    _______________________________________________

Describe in detail the duties performed, including the use of tools, machines or equipment:

________________________________________________________________________

No. of hours per week:    _______________________

• Name and Street Address of Employer:

______________________________________________________

Name of Job:    _____________________________________

Date Started (mm/dd/yyyy):   ____________   Date Left (mm/dd/yyyy):   ____________

Kind of Business:    _______________________________________________

Describe in detail the duties performed, including the use of tools, machines or equipment:

________________________________________________________________________

No. of hours per week:    _______________________

• Name and Street Address of Employer:

______________________________________________________

Name of Job:    _____________________________________

Date Started (mm/dd/yyyy):   ____________   Date Left (mm/dd/yyyy):   ____________

Kind of Business:    _______________________________________________

Describe in detail the duties performed, including the use of tools, machines or equipment:

________________________________________________________________________

No. of hours per week:    _______________________

• Name and Street Address of Employer:

______________________________________________________

Name of Job:    _____________________________________

Date Started (mm/dd/yyyy):   ____________   Date Left (mm/dd/yyyy):   ____________

Kind of Business:    _______________________________________________

Describe in detail the duties performed, including the use of tools, machines or equipment:

________________________________________________________________________

No. of hours per week:    _______________________

• Name and Street Address of Employer:

______________________________________________________

Name of Job:    _____________________________________

Date Started (mm/dd/yyyy):   ____________   Date Left (mm/dd/yyyy):   ____________

Kind of Business:    _______________________________________________

Describe in detail the duties performed, including the use of tools, machines or equipment:

________________________________________________________________________

No. of hours per week:    _______________________

• Name and Street Address of Employer:

______________________________________________________

Name of Job:    _____________________________________

Date Started (mm/dd/yyyy):   ____________   Date Left (mm/dd/yyyy):   ____________

Kind of Business:    _______________________________________________

Describe in detail the duties performed, including the use of tools, machines or equipment:

________________________________________________________________________

No. of hours per week:    _______________________

For more information on Special Handling PERM for University and College Teachers, please click one of the following topics:

• Description
• Eligibility
• Requirements
• Minimally Qualified Requirement vs. More Qualified
• Procedural Criteria
• Documents and Information Needed
• An Example of Special Handling Case
• Frequently asked questions about Special Handling
• General PERM Labor Certification
• PERM Specialty Team