Legal Needs Assessment (Not Citizenship)

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TO BE COMPLETED BY TRAINED PROMOTORES AND TTC PARTNERS

Nombre Completo/Full Name: *

Correo electrónico / E-mail:

Teléfono /Phone number:
*

¿Cuantos años tiene? / How old are you?

¿En qué ciudad vive y Código Postal / City and Zip Code?
*

Nacionalidad/Nationality (Country of Origin):

Cual es su lenguaje de preferencia?/ What is your preferred language?

Inglés/English

Español/Spanish

Other:

Clear selection

Ocupación / Occupation:
*

Construcción//Construction

Servicios//Hospitality

Manufactura//Manufacture

Agricultura y Ganadería//Agriculture and Livestock

Polleras//Poultry

Servicios de limpieza//Cleaning services

Jardinería//Lands keeping

Negocio propio, emprendedor//Own business, entrepreneur

Sin Empleo//No employment

Other:

Usted cuenta con?/ Do you have?

Residencia permanente//Permanent Resident

TPS (If further assistance is needed with TPS, add in comments/Si necesita más ayuda con TPS, agregue comentario)

DACA

VISA (Anotar en otros el tipo de VISA o permiso de trabajo)

Número ITIN// ITIN number

Ninguno de los anteriores//None of the above

Ciudadano que quiere hacer peticion a un familiar// Citizen who wants to make a petition to a family member

Other:

Required

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