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Citizenship Fair Intake/Screening Form
Please complete this intake/screening form. One of our team members will contact you for an appointment or citizenship fair. Enter your information as it appear on your GREEN CARD.
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* Indicates required question
When did you get your green card?
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First Name
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Your answer
Last Name
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Your answer
Date of Birth: Please enter as it appear on your Green Card. We will look at how long you have been in the U.S and how old you are to see if you qualify for the age exception/interpretation.
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Fee waiver: Please answer this question, so we will know if you qualify for a fee waiver. Do you have Food stamp or Medicaid? If yes, which one?
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Your answer
Gender/Sex
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Female
Male
Other:
Country of Birth
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Your answer
Full Address
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Your answer
email
Your answer
Phone number
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Your answer
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