@php $user_info = @$step_verified_data['user_info']; $additional_info = @$user_info->portfolio->userGeneral; $countries = get_countries(); $institution_type_list = config('common.institution_type'); $study_level_list = config('common.study_level'); $relationship = config('common.relation'); $is_itn_user = (!empty($portfolio->placement_agency_id) && $portfolio->placementAgency->checkAgencySync()) ? 1 : 0; $countries_phone_code = get_countries_phone_code(); $dos_program_category_id = $portfolio->dos_program_category_id; @endphp
@if(empty($step_status))
Additional Information
This step is disable until user will reach to step.
@else
1
2
3
4
@if($dos_program_category_id == 3)
5
6
7
8
@else
5
6
7
8
9
@endif
Contact Information
Full Name
Select your Gender
Male
Female
Other
@if($dos_program_category_id == 3)
Driver's License
*
Yes
No
@endif
Phone Number
*
-- Select Country Phone Code --
@foreach($countries_phone_code as $code)
{{ $code }}
@endforeach
Alternative Phone Number
(optional)
-- Select Country Phone Code --
@foreach($countries_phone_code as $code)
{{ $code }}
@endforeach
Second Email Address
(optional)
What is the Best Time to Call You?
Monday to Friday.
*
Morning
(8am to 11am)
Afternoon
(12pm to 5pm)
Evening
(5pm to 8pm)
@if(@$is_step_locked == 1 || $is_itn_user == 1)
Next
@else
Save
Save & Next
@endif
Address
In Care Of / Delivered to (Optional)
Deliver to my name
Street Address
*
Street Address 2
City
*
Zip / Postal Code
*
Country
*
-- Select Country --
@foreach($countries as $country)
country_id,@$additional_info['country']) }} >{{ $country->country_name }}
@endforeach
State
*
@if(@$is_step_locked == 1 || $is_itn_user == 1)
Back
Next
@else
Back
Save
Save & Next
@endif
Passport Information
Passport Number
*
Passport Issuing Date
*
Passport Expiration Date
*
Date of Birth
*
City of Birth
*
Country of Birth
*
-- Select Country --
@foreach($countries as $country)
country_id,@$additional_info['birth_country']) }} >{{ $country->country_name }}
@endforeach
Citizen of
*
-- Select Country --
@foreach($countries as $country)
country_id,@$additional_info['country_citizen']) }} >{{ $country->country_name }}
@endforeach
Legal Permanent Resident
*
-- Select Country --
@foreach($countries as $country)
country_id,@$additional_info['country_resident']) }} >{{ $country->country_name }}
@endforeach
Passport Issuing Country
*
-- Select Country --
@foreach($countries as $country)
country_id,@$additional_info['country_issuer']) }} >{{ $country->country_name }}
@endforeach
@if(@$additional_info->is_step_locked == 1 || $is_itn_user == 1)
Back
Next
@else
Back
Save
Save & Next
@endif
Previous J1 Program
Have you participated in a {{ __('application_term.exchange_visitor_program') }} in the past?
*
Yes
No
Recent Program Name
*
Start Date
*
End Date
*
add another
Oldest Program Name
*
Start Date
*
End Date
*
@if(@$is_step_locked == 1 || $is_itn_user == 1)
Back
@if($dos_program_category_id != 3)
Next
@else
Next
@endif @else
Back
Save
Save & Next
@endif
@if($dos_program_category_id != 3)
Spouse
Marital Status
*
Single
Married
Divorced
Widowed
Will your spouse need J-2 Visa to enter U.S.?
*
No
Yes
Spouse Family Name
*
Spouse Given Name
*
Spouse Middle Name
*
Spouse Gender
*
Male
Female
Spouse Birth date
*
Spouse City of Birth
*
Spouse Country of Birth
*
-- Select Country --
@foreach($countries as $country)
country_id,@$additional_info['spouse_dep_birth_country']) }} >{{ $country->country_name }}
@endforeach
Do you have any other dependents?
*
Yes
No
Spouse enters U.S. at same time with you
*
Yes
No
If not same time, date spouse enters U.S
*
@if(@$is_step_locked == 1 || $is_itn_user == 1)
Back
Next
@else
Back
Save
Save & Next
@endif
@endif
Education
Are you currently a full time student?
*
Yes
No
Educational institution last or presently attending
*
Educational institution type
*
-- Select Option --
@if(!empty($institution_type_list)) @foreach($institution_type_list as $key => $value)
{{ $value }}
@endforeach @endif
Field studied / presently studying
*
Study level
*
-- Select Option --
@if(!empty($study_level_list)) @foreach($study_level_list as $key => $value)
{{ $value }}
@endforeach @endif
Date started studying
*
Date Graduated (estimated or actual)
*
Advance Course worked Completed (if applicable)
Year of experience in the field
@if(@$is_step_locked == 1 || $is_itn_user == 1) @if($dos_program_category_id != 3)
Back
@else
Back
@endif
Next
@else @if($dos_program_category_id != 3)
Back
@else
Back
@endif
Save
Save & Next
@endif
Work Experience
Are you Currently Employed?
*
Yes
No
Name of company
*
Company address
*
Total Number of employees
*
Your {{ __('application_term.position') }}
*
Full Name of supervisor / owner
*
Phone Number
(with Country and Area code)
*
-- Select Country Phone Code --
@foreach($countries_phone_code as $code)
{{ $code }}
@endforeach
Fax Number
(with Country and Area code)
*
Employment start date
*
Computer program skills
(coma separated)
*
@if(@$is_step_locked == 1 || $is_itn_user == 1)
Back
Next
@else
Back
Save
Save & Next
@endif
Emergency Contacts
Emergency Contact First Name
*
Emergency Contact Last Name
*
Phone Number
(with Country and Area Code)
*
-- Select Country Phone Code --
@foreach($countries_phone_code as $code)
{{ $code }}
@endforeach
Alternate Phone Number
(with Country and Area Code)
-- Select Country Phone Code --
@foreach($countries_phone_code as $code)
{{ $code }}
@endforeach
Relationship
*
-- Select Option --
@if(!empty($relationship)) @foreach($relationship as $key => $value)
{{$value }}
@endforeach @endif
Contact Location Country
*
-- Select Country --
@foreach($countries as $country)
country_id,@$additional_info['contact_country']) }} >{{ $country->country_name }}
@endforeach
Contact is English Speaking
*
Yes
No
Language spoken
*
Email Address
*
@if(@$is_step_locked == 1 || $is_itn_user == 1)
Back
Next
@else
Back
Save
Save & Next
@endif
Criminal Background
Have you ever been convicted of a crime?
*
Yes
No
If you selected yes Please explain
*
{!! @$additional_info['criminal_explanation'] !!}
@if(@$is_step_locked == 1 || $is_itn_user == 1)
Back
Next Step
@else
Back
Save
Save & Next
@endif
@endif