PrYSM - RICE Inquiry Form
RICE created this online immigration inquiry form to help community members and their family reach out to us without having to come in person. Use this form for yourself or a loved one who wants to inquiry about their immigration case and options. All information should be of the impacted person, not the supporting family or community member. NOTE: all inquires will be auto-deleted after a certain period of time and intakes encrypted for staff to be able to follow-up with folks in a timely manner and to protect the security of our communities. If you have any questions or concerns, please email Jenni@prysm.us
Name (Preferred)
*
First Name
Middle Name
Last Name
Date of birth
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Month
-
Day
Year
Date
Preferred Phone Number
Please enter a valid phone number.
Ok to leave voicemail or text
Please Select
Ok to leave voicemail only
Ok to leave text only
Ok to leave either voicemail or text
Not ok to leave either
Email
*
example@example.com
Ethnicity (Cambodian, Lao, Hmong, etc)
*
Immigration Status
*
Please Select
Lawful Permanent Resident (Green Card Holder)
U.S. Citizen
Undocumented
Student/Work/Tourist Visa
Unknown
Other
Language(s) Spoken
*
Interpreter Needed
*
Please Select
Yes
No
Back
Next
Immigration History
We need a copy of all your immigration documents filed or received (e.g. passports, “green cards”, work permits, application cards, receipt notices etc.)
If you have an A-Number, please write it here
Any upcoming immigration court dates or pending deadlines? If so, when (give exact dates)?
*
Have you received a Final Order of Removal?
*
Please Select
Yes
No
Not sure
Have you ever had an immigration lawyer?
*
Please Select
Yes
No
Do you go to regular check-ins with ICE?
*
Please Select
Yes
No
Not sure
Have you received a letter to check in early?
*
Please Select
Yes
No
When is your next check-in?
*
-
Month
-
Day
Year
Date
Criminal History
We need a copy of all of your criminal records
Have you ever been criminally arrested in Rhode Island (or elsewhere in the U.S.)?
*
Please Select
Yes
No
Submit
Should be Empty: