EmailMe Form - H-Visa Solutions Employer Information Sheet

APPLICANT INFORMATION

Name *

Visa Type

H-2A

H-2B

Contact Title *

Contact Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

EMPLOYER INFORMATION

Legal Business Name *

Trade Name

DBA

Phone *

### - ### - ####

Fax

### - ### - ####

Business Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Fein *

Previous Year Annual Income *

Projected Annual Income *

EMPLOYEE INFORMATION

Total Number of Full Time Employees *

Year Business Started *

Working Hours Schedule *

Dates Employees Needed (can't exceed 9 moths) *

Total Employees Needed *

Address Where H-2A Employees Will Be Housed

JOB OFFER INFORMATION

Job Title *

Occupation Title

Supervisor Name

Does Position Supervise *

Yes

No

Job Description *

Traval Required *

Yes

No

If yes; where (please annotate county and state) *

List all counties workers will be in

Education Requirements *

None

High School

Bachelors

PLACE OF EMPLOYMENT

Worksite Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Additional Notes