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user-list
U-Visa Questionnaire
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4
Questions
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1
Have been a victim of a crime and physical or mental abuse and cooperated with the police to investigate and prosecute the crime?
*
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YES
NO
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2
Name
*
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First Name
Last Name
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3
Phone Number
*
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Area Code
Phone Number
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4
Email
*
This field is required.
example@example.com
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