Intake Form for U.S. Citizens and Green Card Holders in Need of Evacuation from Lebanon
The Arab American Civil Rights League (ACRL) has set up a dedicated hotline to assist U.S. citizens and green card holders needing evacuation from Lebanon. Please complete the following intake form to help us document your situation and facilitate the necessary support.
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U.S. Point of Contact Name
U.S. Point of Contact Immigration Status (U.S. Citizen or Green Card Holder):  
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Email Address
Phone Number
Address in the US
  Date of birth   
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Occupation in the US
Evacuation Details
Names of Individuals Needing Evacuation, their ages and immigration status (Please specify if they are a U.S. Citizen/ Green card holder)
Total Number of Family Members Needing Evacuation
Please provide a brief description of the current situation in Lebanon for you and your family.
Have you completed the State Department's Crisis Intake Form?

* If not, please complete the form here ASAP: https://mytravel.state.gov/s/crisis-intake
Medical Information (if applicable)
Do any individuals needing evacuation have medical emergencies or conditions we should be aware of?
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If yes, please provide details:
Additional Information
Current Location in Lebanon
Have you attempted to secure evacuation from Lebanon?
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If yes, please provide details on the outcome
Would you be interested in joining a class action lawsuit regarding the failure to provide timely and coordinated evacuations for Lebanese Americans?

Note: This is not a commitment, just a request for more information.
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I consent to share this information with the Arab American Civil Rights League and relevant authorities for the purpose of evacuation assistance
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Submission Instructions
Please ensure all information is accurate and complete. Once submitted, our team will review your request and contact you for further assistance.
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