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DACA Eligibility Questionnaire
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9
Questions
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1
Were you less than 31 years old on 06/15/12?
*
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YES
NO
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2
Did you enter the United States before your 16th Birthday?
*
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YES
NO
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3
Have you been living continuously in the US since 06/15/2007?
*
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YES
NO
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4
Were you physically present in the US ON 06/15/2012?
*
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YES
NO
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5
Are you enrolled in school, or have proof completed highschool or have GED certificate?
*
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YES
NO
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6
Have you ever been convicted of a Felony offense, significant misdemeanor offense, or three or more misdemeanor offenses not occurring on the same date or from the same act?
*
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YES
NO
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7
Name
*
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First Name
Last Name
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8
Phone Number
*
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Area Code
Phone Number
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9
Email
example@example.com
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