SUBMISSION FORM

Click download on the top left then complete this form in full and
return it to us by email to: submission@VisaWest.com

For a full assessment, we require your resume (CV) attached to this form.
First names:
Last name:
Age:
Date and place of birth:
Country of citizenship:
Second citizenship (if any)
Current address:

Mailing address, if different:

Telephone number:
Email:
Website (if any)
Skype:
Visa type requested (please circle)

O-1

EB-1

If any other visa type requested, state here:

Current US immigration status:

Have you ever had any US visa application declined or withdrawn?
If so, please explain.

EB-5

Do you have any relatives in the US? If so, provide full details:

Your present employers name and address in your current country of residence:

For O-1 applications (actors, models, writers, producers, directors, performers,

editors and any other entertainment industry professionals) do you have any
agency or management representation in the U.S?
If so, give company name, address, contact name, email and telephone #

For O-1 applications, do you have a sponsor /petitioner in the U.S.?

If so, give company name, address, contact name, email and telephone #

Do you have any of the following:

National or international awards

Featured articles in the press
TV / online / radio interviews
Recognition of distinction by official authorities or the media

If so, give full details

For a full assessment, we require your resume (CV) attached to this form.
Click download on the top left then complete this form in full and return it to us by
email to: submission@VisaWest.com
For a full list of recognitions and criteria to be met under the Extraordinary Ability
(O Type visa category) visit our website www.VisaWest.com
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30 Faraday House Velocity Way Enfield Lock EN3 7FE UK
8241 Whitsett Ave. Suite 14 North Hollywood CA 91605 USA
Visa West is an intermediary consultant agency We are NOT licensed immigration lawyers