Citizenship Program Application Form
Spring 2021 / Online classes
All information provided on this form is confidential and is used by staff only.
Email *
Applicant's Full Name *
Date of birth *
Gender *
Country of Origin *
How many years have you been a legal permanent resident of the United States? *
Write your Alien Number (USCIS A-Number) *
Have you sent your application for citizenship? *
If yes, when did you send your application?
Current address *
Email address *
Telephone number *
Write the full name of an emergency contact *
Emergency contact phone number *
Highest level of education completed *
Are you currently working? *
If you are currently working, how many hours a week do you work? *
Can you afford the class fee of $30? *
Have you taken classes at Manos de Cristo before? *
If yes, which classes have you taken?
Do you have internet access in your home? *
Do you own a computer? *
Do you have experience using any of the following: *
Are you interested in purchasing a low-cost computer or Wifi hotspot? *
Choose your preferred schedule: (we cannot guarantee that your preferred schedule is available)
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This form was created inside of Manos de Cristo.