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Preferred First Name: (Optional)
Country of Citizenship: * --- Select Choice --- Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Central African Republic Chad Chile China Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czechia Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria North Korea North Macedonia Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea South Sudan Spain Sri Lanka Sudan Suriname Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates (UAE) United Kingdom (UK) United States of America (USA) Uruguay Uzbekistan Vanuatu Vatican City (Holy See) Venezuela Vietnam Yemen Zambia Zimbabwe
If Yes, what is your current U.S. visa status? B1/B2 Visitor F1 Student H-1B Other None
If other, please specify:
o If Yes, please provide your I-94 Arrival/Departure Record number (Optional):
Name of Nursing School/University: *
Type of Nursing Degree: * --- Select Choice --- Bachelor of Science in Nursing (BSN) Associate Degree in Nursing (ADN) Diploma in Nursing Other
If other, please specify:
other, anything or
if other, please specify:
What type of U.S. visa are you interested in? * --- Select Choice --- EB-3 Immigrant Visa H1B visa Other Not Sure
If other, please specify:
If Yes, please identify your top 3 preferred U.S. states:
If No, which states are you interested in working in?
If Yes, please provide details (date, location, nature of offense):
Please describe your reasons for wanting to work as a nurse in the U.S. *
If Yes, how many are migrating with you?
How did you hear about this opportunity? * --- Select Choice --- Website Social Media Referral Other
If other, please specify:
Is there anything else you would like us to know?