2021 New Client Application
Thank you for applying to become a new client of AsylumWorks (formerly known as the Asylum Seeker Assistance Project. AsylumWorks (AW) is a nonprofit organization dedicated to serving asylum seekers and their families. AW operates social service, community, and employment programs designed to ensure client safety and wellness, build social and professional networks, and help to secure safe, legal, and meaningful employment. All of our programs are FREE.

To be eligible for AW services, applicants must:

● File their I-589 (asylum application) before applying for services OR be actively working to do so, and;
● Live in the D.C. Metro region

If you would like to become a new client, please complete the following application. A friend, family member, or service provider can help you. Please complete one application per adult.

With the exception of the section marked "confidential," the information you provide on this form may be used for reporting purposes. All reported information will be thoroughly de-identified (i.e. personal information like names and addresses will not be shared) and reported in aggregate form (i.e. one large group). AW takes great care to protect the anonymity of our clients.

Thank you for taking the time to fill out the pages of the form below. We look forward to working with you!
Basic Information
First Name *
Last Name *
Phone Number *
Email Address *
Preferred Method of Contact *
Required
Current Zip Code *
Country of Origin/Nationality *
Ethnicity *
(ex. Aimaq, Akposso, Amhara, Bambara, Basque, Ewe, Gbaya, Hispanic, Javanese, Lisu, Tigre, etc.)
Religious Affiliation *
(if applicable)
Date of Birth *
MM
/
DD
/
YYYY
Preferred Language for Services (if needed, AsylumWorks can arrange for free interpretation) *
Gender *
Required
Do you identify as part of the LGBTQIA+ community? *
What are your preferred pronouns?
Are you parenting children in the U.S.? *
If so, how many children are you parenting in the U.S.? If none, please type "N/A" or "none" *
What are the ages of your children in the U.S.? *
Required
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