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1. Name (Nombre)*

2. Date of Birth (Fecha de Nacimiento)*

3. Country of Origin (Nacionalidad)*

4. Telephone/Telefono*

5. Your Email (Correo Electronico)*

6. Current Immigration Status

US Citizen (cuidadano)

Permanent Resident

Temporary Resident

Undocumented (Sin estado)

Asylee/Parolee

7. Assistance Required*

8. Select Applicable Immigration Forms (Seleccione los formularios de inmigración aplicables)*

Form I-130: Petition for Alien Relative

Form I-130A: Supplemental Information for Spouse Beneficiary

Form I-485: Application to Register Permanent Residence or Adjust Status (Green Card)

Form N-400: Application for Naturalization (Citizenship)

Form I-589: Application for Asylum and for Withholding of Removal

Form I-765: Application for Employment Authorization

Form I-539: Application to Extend/Change Nonimmigrant Status

Form I-601A: Application for Provisional Unlawful Presence Waiver

Form I-912: Request for Fee Waiver

Form I-914: Application for T Nonimmigrant Status (T Visa)

Form I-360: Petition for Amerasian, Widow(er), or Special Immigrant

Form DS-260: Immigrant Visa and Alien Registration Application (Consular Processing)

Form DS-160: Non-immigrant Visa Application (Visitor's Visa)

Form I-864: Affidavit of Support

Form I-131: Application for Travel Document

Form I-134: Declaration of Financial Support

Referral Information

10. By submitting this form, I grant the representatives of Valrie Cares Immigration Services Inc to contact me via (Al enviar este formulario, otorgo a los representantes de Valrie Cares Immigration Services Inc. el derecho a contactarme a través de:):*

Telephone

Text message

Si desea servicios de inmigración, gestión de casos o apoyo en la preparación de impuestos a bajo costo..contacta con nosotros!

Support

Empowering immigrants through accessible services and support.

Services

Community

valrie.b@valriecares.orgvalrie.b@valriecares.org

Call: 770-524-0876

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