Language
English (US)
Pashto
Money and Financial Workshop
Registration
Name
*
First Name
Last Name
Birth Date
-
Month
-
Day
Year
Date Picker Icon
Entrant Status
Please Select
Refugee
Asylee
Humanitarian Parolee
SIV
Amerasian
Victim of Trafficking
Cuban/Haitian Entrant
Date of arrival to the US (asylees please list date granted asylum)
-
Month
-
Day
Year
Date Picker Icon
Your USCIS Alien Registration Number
Gender
Please Select
Female
Male
Other
Home Country
*
First Language
*
Do you need an interpreter in class?
*
Please Select
Yes
No
Not sure
If you need interpretation in a language other than your first language, enter that language here:
Marital Status
Please Select
Never Married
Married
Divorced
Widowed
Separated
Phone Number
*
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
USCIS Alien Registration Number (8-9 digits)
Do you (the student) have Wifi or internet access at home?
Please Select
Yes
No
I don't know
Are you a case manager or someone else completing this on behalf of a client? If yes, please list your name and contact information below:
Please Select
Yes
No
Case Manager/Assister Name
First Name
Last Name
Case Manager/Assister Phone Number
Please enter a valid phone number.
Case Manager/Assister Email
example@example.com
How did you hear about this course?
Please Select
Received a phone call
IIM Facebook
Facebook-a community organization
Email
Text message
Someone told me about it
Other
If Other, please tell us how you heard about the course:
Workshops are available in June and July. Choose the type of workshop you want to attend:
*
Online Class (over Zoom) with one in person lab
In-person class
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