2019 Encampment for Citizenship Application
Please complete each section attached to this application. If you are applying for funding assistance, you must submit a fee waiver application (see Section 4 for details).
Name *
Street Address *
City, State, Zip *
Date of Birth *
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DD
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Your Email *
Please provide best phone number(s) and 3 possible appointment times in next 2 weeks for your interview--best would be to arrange with your parent/guardian(s) so s/he/they can be interviewed at the same time. If not, provide 3 times for her/his/their interview in the Parent/Guardian section. *
Place of birth *
How do you describe your racial/ethnic and gender identity? Your answer will help us ensure that the Encampment community includes people from many different backgrounds. *
Please list your parent/guardian(s) and their relationship(s) with you (example: mother, aunt, etc.) *
Parent/Guardian(s) occupation(s) *
Parent/Guardian(s) email(s).
Please provide best phone number(s) and 3 possible appointment times in next 2 weeks for Parent/Guardian(s) interview--best would be to arrange with your applicant interview so you can be interviewed at the same time. If not, provide 3 times for your own interview in the Applicant section above. *
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