No One Left Behind Immigration Assessment
Please fill out this form with as much information as possible so that we can fully understand your case. This form is ONLY for SIV applicants concerned with immigration, not for SIV recipients already in the United States.
First Name *
Your answer
Last Name *
Your answer
E-mail Address *
Your answer
Date of Birth *
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Where are you from? *
Skype Name
If you do not have skype, you can skip this question.
Your answer
Which Province/City are you from in Iraq or Afghanistan? *
Your answer
What country are you currently in? *
Example: Iraq, Afghanistan, Turkey, Greece, Germany, etc.
Your answer
What language(s) do you speak? *
Required
What is your case number? *
Please add your 3-Letter designation (KBL, BGH, or NVC)
Your answer
Date First Applied for Special Immigration Visa (SIV) *
If you have not yet applied for SIV, then put today's date.
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Have you applied for Special Immigration Visa (SIV) more than once? *
If you have applied for Special Immigration Visa (SIV) more than once, how many times and on what dates?
Your answer
Have you received COM approval yet? (COM: Chief of Mission) *
When did you receive COM approval?
If you have not yet received your COM approval, then go to the next question.
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Have you completed your interview for SIV (Special Immigrant Visa) yet? *
When did you interview for Special Immigration Visa (SIV)?
If you have not yet interviewed, then go to the next question.
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What is your current case status? *
Are you in contact with any of your US friends / supervisors? *
It does not matter if they are still in Afghanistan/Iraq or if they are currently in the military or if they retired.
Please list names and contact information (e-mail addresses, skype usernames, phone numbers...) for your US friends who may be willing to help with your case. *
It does not matter if they are still in Afghanistan/Iraq, if they are in the USA, if they are currently in the military or if they retired.
Your answer
Are there any potential problems with your case? *
Please be 100% honest, even if your case is still pending. We need to know who needs help and for what reasons. Please select any that apply to you.
Required
If you appealed your case, when did you send your appeal?
If you have not appealed, skip this question.
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If your appeal was denied, when did you receive the denial?
If you have not appealed, skip this question.
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Have you or your friends been in communication with any US Congressmen? Please list their names.
If you have not, skip this question.
Your answer
Is there anything important that we need to know about the work that you were doing? *
For example, were you injured in combat? Did you have any special responsibilities? This will help us explain your case.
Your answer
Is there anything important that we need to know about the threats against you? *
We understand that you are in danger, and we are doing everything that we can to help. We need to know this information so that we can share with the media and Congress the urgent danger that our clients are in.
Your answer
What type of work were you doing in Afghanistan or Iraq? *
Select as many jobs as apply.
Required
Do any of the following apply to your case? Please select any that apply.
Currently, if any of these apply to you, we do not have a solution. However, we are collecting this data so that we can report to Congress the number of people in your particular situation.
Do you have an American attorney working on your case? *
Have you contacted IRAP regarding your case? *
Would you be willing/interested in talking to journalists regarding your case? *
If need be, we can change your name/hide your face/not use pictures.
No One Left Behind is NOT a part of the government. We cannot send you a Visa and we cannot approve your SIV case. We will contact you as soon as possible and we will do everything within our power to help you come to the US. Please select that you understand that we are not promising you a visa. *
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