January 22 Domestic Violence/Family Law Legal Clinic Service Request
All information provided will be kept confidential.
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Your Name *
Email Address *
Your Phone Number *
May we leave a voicemail on the number provided? *
What county do you live in? *
What is your preferred language for communicating? (i.e. English, Spanish, Mandarin Chinese) *
Are you currently employed? *
What is your monthly income? *
How many people live in your household? *
What is your household income? *
Please tell us in 1-2 sentences what you need assistance with. *
You will have the option to meet with a legal team virtually (phone/video call) or in person at Santa Clara University on 1/22/2022. Which do you prefer? *
How did you hear about this clinic? *
Submitting your information does not create an attorney-client relationship between you and Elevate Community Center. There is no guarantee that Elevate Community Center will provide you with any services, legal or otherwise. We will attempt to contact you three times before moving onto the next person. You can email info@elevatecommunitycenter.org or call us at 408-357-9538 with any questions. If you understand and agree, please acknowledge your agreement by typing your name below. *
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