Ezekwere Law- Intake Form

1

What is your name?* This field is required.

First Name

Last Name

2

What is your Phone Number?* This field is required.

3

What is your Email?

example@example.com

4

Are you a U.S. citizen? * This field is required.

YESNO

5

Are you a lawful permanent resident?

YESNO

6

Do you want to petition for a relative?

YESNO

7

Are you married to a U.S. Citizen?

YESNO

8

Is your relative a U.S. citizen?

YESNO

9

Is your relative a green card holder?

YESNO

10

Have you been a victim of domestic abuse?

YESNO

11

Have you assisted the government in a crime?

YESNO

12

Were you brought to the U.S as a child?

YESNO

13

Are you the fiancé(e) of an U.S. citizen or the child of a such a fiancé(e)?

YESNO

14

Are you an Immigrant worker?

YESNO

15

What is your nationality?* This field is required.

16

What is your immigration issue?* This field is required.

17

Our admin will contact you shortly.

18

What is your current immigration status? If Out of Status please explain what occurred in detail, i.e. How did you enter? How long you have been out of status?