APS Representative's Name (required)
Complete Company Name (required)
Taxpayer FEIN (required)
Doing Business As/Trade Name (if different from above)
Type of Entity (required)
-
Individual
Corporation
Partnership
LLC
Other
Where and When Incorporated or Established (state and year) (required)
Number of Company Employees (required)
Gross Revenue of Past Year (required)
Worker's Compensation Insurance Carrier Name (required)
WC Policy # (required)
WC Expiration Date: MM
JANUARY
FEBRUARY
MARCH
APRIL
MAY
JUNE
JULY
AUGUST
SEPTEMBER
OCTOBER
NOVEMBER
DECEMBER
DD
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2023
2024
2025
2026
2027
2028
2029
2030
WC Contact Person (required)
WC Contact Phone # (required)
Name of Company Owner or President (required)
Website Address
E-mail Address (required)
Mailing Address (required)
Street Address (required)
Worksite Address (required)
Main Office Phone # (required)
Person Responsible for the TN Visa Application process (required)
Title (required)
Main Phone # (required)
Cell Phone # (required)
E-mail Address (required)
Have You Previously Participated in the TN Visa Program? (required)
If You Anticipate Hiring TN Visa Holder(s) for More Than One Job Category, Occupation or Profession, Please Duplicate Pages 3 and 4, Being Sure to Provide Separate Information for Each Job Category, Occupation or Profession. If You Need More Space, Clearly Label and Attach a Separate Sheet of Paper. Please Provide a Brief Summary of Your Business Operations Including the Numbers of Employees, Animals, and Locations. (required)
Please Indicate Job Title or Name You Want to Call the Job for Which You Anticipate Hiring TN Visa Holder(s). (required)
Please Describe This Job. (required)
How Many TN Visa Holder(s) Do You Plan on Hiring for This Job? (required)
What Date Would You Like the TN Visa Holder(s) to Start Working? MM
JANUARY
FEBRUARY
MARCH
APRIL
MAY
JUNE
JULY
AUGUST
SEPTEMBER
OCTOBER
NOVEMBER
DECEMBER
DD
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2023
2024
2025
2026
2027
2028
2029
2030
Do You Want the TN Visa Holder(s) to be Available for Continuous employment or would a specific employment period be preferable? (required)
-
Continuous with annual renewals
Specific ending date
What is the Address Where TN Visa Holder(s) Will Work? (required)
What Work Schedule Should Your TN Visa Holder(s) Expect During the Time of Employment? Mon-Fri Start and Finish time (required)
Anticipated Total Hours Per Week (required)
Is Saturday Work Required? (required)
How Often Do You Pay Your TN Visa Holder(s)? (required)
-
Weekly
Bi-weekly (once every two weeks)
Other
If You Pay Weekly or Bi-weekly, Which Day of the Week is Payday? (required)
What is the Minimum Starting Amount You Would Expect to Offer TN Visa Holder(s) With a Bachelor’s Degree in an Appropriate Discipline for the Job Duties Described Above? Please Specify the Mount and Whether It is Per Hour, Per Week, or Per Month. (required)
Do You Intend to Offer or Assist TN Visa Holder(s) in Securing Housing or Other Boarding Facilities Upon Arrival? (required)
If Yes, Please Describe the Housing (e.g., Furnished Apartments, Rental Home, Mobile Home, etc.). If Housing Has Not Yet Been Determined, Please Indicate “TBD.” (required)
If known, Please Provide Estimated Housing Costs Per TN Visa Holder(s) Per Week (required)
Rent Per TN Visa Holder(s) Per Week (required)
Basic Utilities for Which TN Visa Holder(s) Will Be Responsible and Which Are Not Included in Rent (required)
Total Rent And Utilities Per TN Visa Holder(s) Per Week (required)
Please provide three references. One of the three must be either your veterinarian or breeder (for livestock industry clients only): Reference 1 Name (required)
Relationship
Phone # (required)
Reference 2 Name (required)
Relationship
Phone # (required)
Reference 3 Name (required)
Relationship
Phone # (required)
Please Provide Other Information That Could Help Us Identify And Train Prospective Employee(s)
Letter Proving Legitimacy of Your Business (Such as a Financial Statement or Certificate of Existence from the Department of the Secretary of State from the state where your business is registered)
Download File: TN Visa Agency and Indemnity Agreement. Sign And Upload
Send