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Pre-Screening Form for Free Eviction Prevention Legal Clinic
Fill out this form to see if you qualify to get free legal advice about eviction from an attorney at the City of Albuquerque clinic on May 25th, 2022. The information you provide will only be used to see if you qualify for this clinic and will not be shared or used in any other way. A city representative will contact you for more information after you submit this form.
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Email *
Preferred Language *
Your full legal name including all middle names and last names   *
Date of Birth DD/MM/YY *
MM
/
DD
/
YYYY
Who is your landlord?
Your Street Address *
City/County *
State *
Zip code *
Phone number *
Gender Identification *
Race *
Ethnicity *
Immigration Status *
Household Income *
Number of people in household *
Disability Status *
Veteran Status *
Education Level *
Have you applied for Emergency Rental Assistance (ERAP)  ? *
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