H1B visa and Permanent Residency Initiation Form – Hiring Unit

University of Illinois at Springfield

Office of International Programs

Brookens 480

One University Plaza, MS BRK 480

Springfield, Illinois 62703-5407

Phone: (217) 206-8319/ Fax: 206-7415/ E-mail: intprog@uis.edu



This college requests that International Programs (IP) begin procedures for applying for an H1 visa and, subsequently, permanent residency for the employee named below.


Employee’s Name:                                                                                            


Employee’s campus address (if known):                                                            


Employee’s mailing address:                                                                              



E-mail address:



UIS Department name:


Contact person:


Campus address:


Mail Code:





Title of permanent position:


Job title of immediate supervisor:



Annual rate of pay: $

(Please attach a copy of the job offer letter).



Job description (must include teaching duties). Make description generic by not using alien’s name or saying “he” or “she”:                                                                                                                                       




Is employee currently in the position: □ Yes           □ No Type of position (check one):

  • Teaching position:


  • Non-teaching position:

(Attach a brief written statement, signed by the department head, describing expected availability of funding for this position for five years).


Was position filled pursuant to a search? □Yes     □No

If yes, date of offer letter to employee:                                              If yes, was ad posted in print in a national publication?                     □Yes □No


Name of national professional journal(s) in which ad appeared (list primary publication first):



Date of Journal in which ad appeared:


Describe additional recruitment conducted (e.g., other journals, newspapers, web postings, etc.).


Minimum educational requirements for the position:

Degree – Please check one






Major field(s) acceptable for the position:                                                                             


Required years experience (normally 0 for assistant professors):                                           


Number of other employees to be supervised (if any):                                 


Is knowledge of a foreign language required?

Yes. Language                                    


In order to apply for permanent residency UIS needs to demonstrate that the position offered to a foreign national is permanent, the equivalent of a tenure track line position and that the recruitment for the position was competitive and consistent with UIS policy.


I,  _____________________________________, certify that to the best of my knowledge that both the position and the employee are considered to be permanent and that this appointment is consistent with UIS policy.





Signature of Department Head/College Dean                            Date