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Greenstaff Medical International
H1B Visa Interest Form
Name
*
First
Last
Email
*
Contact Number
*
Date of Birth
*
MM
/
DD
/
YYYY
Country of Birth
*
Country where you currently live in
*
What best describes you?
*
Medical Laboratory Scientist (MLS)
Medical Laboratory Technologist (MLT)
Histotech
Have you passed the ASCPi?
*
Passed
Failed
Scheduled
Date you've passed your ASCPi exam (If completed)
MM
/
DD
/
YYYY
Do you have an active CGFNS visa screen?
*
Yes
No
If Yes, please state the expiration date
MM
/
DD
/
YYYY
Upload Resume
*
