Citizenship Workshop May 3rd, 2025-GENERAL REGISTRATION

First Name*
Last Name*
Phone Number*
Click "I agree" if you want to receive text messages. Msg & data may apply. (Not required for enrollment)

I agree to receive SMS.
Email Address*
example@example.com
Click "I agree" if you want to receive email updates from HUF. (Not required for enrollment).

I agree to receive emails.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country of origin*
How would you describe your gender?*

MaleFemaleOther
How would you best describe yourself?*
Are you of Hispanic, Latino or Spanish origin?*
Please think about language, history, society, traditions and customs.
Level of Education*
Number of People living at home:*

1. Are you a Lawful Permanent Resident?*

YesNo

2. Does any of the following conditions apply to you?

I recently applied for U.S. CitizenshipI claimed to be a U.S. Citizen (In writing or any other way)I registered to vote in any Federal, State or local election in the U.S.I voted in any Federal, State or local election in the United StatesI lied to an U.S. Government official to gain entry or admission into the U.S.I failed to support a dependent or pay alimonyNone of the above

ACKNOWLEDGMENT OF PROGRAM POLICIES AND REQUIREMENTS (Required for Enrollment) Read the program policies and requirements below.
CLIENT RIGHTS

All clients shall enjoy all of their legally entitled rights, and in addition, can expect the following rights to be honored while receiving services at Hispanic Unity of Florida, Inc. (HUF): Access to all of the services we provide and/or referral to other appropriate organizations/services (based on individual need); To be treated with respect and served in a culturally appropriate and sensitive environment; To receive requested information/assistance/referral in a timely manner and be served in an environment free from all forms of harassment; To be given the opportunity to provide feedback to the President/CEO and the Board of Directors regarding the service they are receiving; Upon enrollment, to be able to freely choose to participate or cease to participate in any of the agency’s services, and to be aware of grievance procedures that may be utilized when needed.

CONFIDENTIALITY AGREEMENT

HUF recognizes that any information obtained is of a confidential nature. HUF and its employees agree to fully comply with preserving confidentiality and agree not to divulge or discuss confidential information for any purpose or in any matter not in conformity with the State of Florida or Federal law, except for the purpose of administrating this program. I do hereby release HUF, its officers, agents, and employees from and against any and all claims or demands of any kind or nature that may accrue in my favor on account of my participation in the program. This includes any activity or event sponsored by HUF during the program. The provisions of this release and hold harmless shall apply whether or not the claim or demand results in whole or in part from any negligent or contributory negligent act or omission on the part of HUF, its officers, agents or employees, or any combination thereof. Nothing in this agreement shall be construed to affect the rights, privileges, and immunities of HUF under the doctrine of “Sovereign Immunity” and as set forth in Section 768.28 statues.

GRIEVANCE PROCEDURES

If you feel that your services have been denied incorrectly or have not been provided fairly or reasonably, you may present your concerns, verbally and in writing, within three (3) business days following such action, to supervisory staff who will review the circumstances and render a decision within three (3) business days of receiving your complaint. If the matter is not resolved to your satisfaction, you may send a written request to the agency’s grievance committee chairperson, who will investigate and assign a hearing date for you to present your case before the grievance committee within three (3) business days from the date they receive your request. You will have a final decision within four (4) business days following your hearing. Forms and a copy of the complete appeals/grievance policy are available from any HUF office. You have a right to seek legal recourse, through your own independent counsel if you believe that civil rights or confidentiality laws were violated in your case; however, you may request to resolve the issue through the agency’s appeal/grievance process.
Signature - I have read and understood the agency policies outlined above*

Clear

Photo Release

(Not required for enrollment)
I give and grant for unlimited usage in perpetuity to Hispanic Unity of Florida (HUF) the right to record, use, copy, and publish my name and other identifying information about me (age, state of residence, first name), picture, portrait, voice, statements made by me, pictures of original creative content made by me and my likeness in unlimited universal media, whether print or electronic, including, without limitation, HUF webpages and HUF’s social media properties. I further acknowledge and agree as follows:

·       I agree that all images, photographs and/or video and/or voice recordings of me used or taken by the “Licensed Parties” are owned by them and that they may copyright material containing the same. If I should receive any print, negative or other copy thereof, I will not authorize its use by anyone else.

·       I agree that no materials need be submitted to me for any further approval and the “Licensed Parties” shall be without liability to me for any use, distortion or illusionary effect resulting from the recording, use, copying, or publication of my name, voice, picture, portrait, likeness, statements, creative works or identifying information.

·       Nothing herein will constitute any obligation on the “Licensed Parties” to make any use of any of the rights set forth herein.
YesNo

You MUST bring all the required documents to your appointment for each applicant. See list of required documents below. You MUST also print, complete, and bring the following forms filled out. Failure to do so will result in longer waiting times. To ensure that you have submitted your appointment, scroll down and click "submit" button". You will receive a submission received notice.
Your case requires special attention. Please contact one of the following organizations for further assistance. (Please scroll down and click "submit" button")

Su caso requiere una atención especializada. Por favor comuniquese con las siguientes instituciones (Por favor haga click en el boton de submit):
Your case requires special attention. Please contact one of the following organizations for further assistance. (Please scroll down and click "submit" button")

Su caso requiere una atención especializada. Por favor comuniquese con las siguientes instituciones (Por favor haga click en el boton de submit):
Should be Empty:

Photo Release