Permanent Residency: Extraordinary or Outstanding Ability in the Arts, Sciences, Business, Education or Athletics Complete this questionnaire and return to the address below.

Family Name

First Name
Middle Name

Date of Birth (Month/Day/Year) / /

/

Gender: [ ] Male [ ] Female

Country of Birth:

/

Citizenship:

U.S. Social Security Number, if any:

Current Home address:

Telephone: Fax:
E-Mail address:

Highest Academic Degree:

Major Field of Study:

Current Occupation:

Name of Department:

Name of Supervisor:

Address of Current Worksite:

Processing (Select the manner in which you plan to obtain your permanent resident status):

At U.S. consulate located at ______(city), ______(country)
Adjustment of status inside the U.S. from another classification

Passport Number:

Passport Expiration Date:

Has a petition for Permanent Residency ever been filed on your behalf?

[ ] No
[ ] Yes (explain):
Have you ever held J-1 status?
[ ] No
[ ] Yes: Did/do you have a two-year home residency requirement?
[ ] No [ ] Yes
Have you gotten a waiver of this requirement?
[ ] Yes (attach a copy of waiver)
[ ] No (explain):

Current status in the U.S. (Complete only if currently in the U.S.):

Current Nonimmigrant status: _____ Expiration of current status: _____/_____/______

Date of last Entry into the U.S.: ______/_____/ ______
I-94 card #: ______Status upon last entry into the U.S.: ______
Do you have dependents (spouse and/or children under 21 years of age) who will obtain permanent residency through you?
[ ] No [ ] Yes, please complete below.
Name: ______
Relationship: [ ] husband [ ] wife [ ] son [ ] daughter
Date of Birth: ______/_____/_____ Country of birth: ______
Name: ______
Relationship: [ ] son [ ] daughter
Date of Birth: ______/_____/_____ Country of birth: ______
Name: ______
Relationship: [ ] son [ ] daughter
Date of Birth: ______/_____/_____ Country of birth: ______
Name: ______
Relationship: [ ] son [ ] daughter
Date of Birth: ______/_____/_____ Country of birth: ______
Present address, if different from yours: ______
The information provided in this request form is true and accurate to the best of my knowledge.
Signature: Date:
As evidence of extraordinary/outstanding ability, I can provide the following documents to support the following criteria (check all that apply). Please note: it is not necessary that each of these apply in your particular case.
Receipt of major prizes or awards for outstanding achievement in the field:
______
______
Membership in professional associations which require outstanding achievements of their members:
______
______
Evidence of authorship of scholarly books or articles in the field that have appeared in professional journals or other major media:
Published material in professional publications or major media about you and your work. List publication or media sources:
______
______
Evidence of participation on a panel, or individually, as the judge of the work of others:
Evidence in the form of letters or affidavits from prominent colleagues who can confirm your original, significant scientific or scholarly contributions to the field (please provide information on these colleagues on the pages that follow.)
Evidence that you have commanded a high salary or other significantly high remuneration for services, in relation to others in the field
For Artists/Performers:
Evidence of the display of your work in the field at artistic exhibitions or showcases.
Evidence of commercial success in the performing arts, as shown by box office receipts or record, cassette, compact disk, or video sales.
Other comparable evidence:
Name and Title / Contact information
Address
Telephone:______
Fax: ______
e-mail:
Address
Telephone:______
Fax: ______
e-mail:
Address
Telephone:______
Fax: ______
e-mail:
Address
Telephone:______
Fax: ______
e-mail:
Address
Telephone:______
Fax: ______
e-mail:
Address
Telephone:______
Fax: ______
e-mail:
Address
Telephone:______
Fax: ______
e-mail:
Address:
Telephone:______
Fax: ______
e-mail:
Address:
Telephone:______
Fax: ______
e-mail:

Return to: International Student and Scholar Services

Attn: Roy Braine

The CatholicUniversity of America

111 McMahon Hall, WashingtonDC20064

Telephone (202) 319-5618 Fax (202) 319-6673

Extraordinary/Outstanding Ability Checklist

This is intended for reference purposes only.

Employee checklist of documents needed for the outstanding researcher petition.

Copy of my acceptance of the job offered me

Copy of my C.V.

Copies of my diploma(s) with English Translations

Copies of any licenses, certifications needed to perform my job

Evidence of outstanding ability. As evidence of outstanding ability, I can provide the following documents to support the following criteria (check all that apply):

Receipt of major prizes or awards for outstanding achievement in the academic field

Membership in professional associations which require outstanding achievements of their members

Evidence of authorship of scholarly books or articles in the field that have appeared in professional journals or other major media

Published material in professional publications or major media about you and your work. List publication or media sources

Evidence of participation on a panel, or individually, as the judge of the work of others

Evidence in the form of letters or affidavits from prominent colleagues who can confirm your original, significant scientific or scholarly contributions to the field

 Evidence that you have commanded a high salary or other significantly high remuneration for services, in relation to others in the field

Other comparable evidence:

For Artists/Performers:

Evidence of the display of your work in the field at artistic exhibitions or showcases.

Evidence of commercial success in the performing arts, as shown by box office receipts or record, cassette, compact disk, or video sales.

Other comparable evidence:

If in the U.S., copies of passport, I-94 card, and (check those that apply):

I-797 approval notice, if in O or H-1B status

I-20 if in F-1 status

IAP-66s if in J status and evidence of waiver, if applicable

Employment authorization document (EAD), if applicable

check or money order, payable to DHS to cover processing fee