JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Contact Checklist/Lista de verificación de contacto/
Welcome to the
Louisiana Organization of Refugees and Immigrants
(LORI),
and Thank you for reaching out to us with your valuable concerns.
We are delighted to meet you and hope that we can assist you in the best way possible.
To schedule a meeting with us, kindly fill out this form and let us know the basics and nature of your visit and the required services. It will assist us in serving you better.
Thank you again for your patience. We look forward to meeting with you.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name/ Nombre
*
Your answer
Phone / Numero de Telefono
*
Your answer
Email: / Correo Electrónico:
*
Your answer
Address: / Direccion:
*
Your answer
City / Cuidad
*
Your answer
State / Estado
*
Your answer
Country of Origin / Pais de Origen
*
Your answer
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Louisiana Organization for Refugees and Immigrants.
Does this form look suspicious?
Report
Forms
