PrYSM Immigration 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 NameMiddle NameLast Name

Date of birth

Date

Preferred Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Ok to leave voicemail or text

Email

example@example.com

Ethnicity (Cambodian, Lao, Hmong, etc)

Immigration Status

Language(s) Spoken

Interpreter Needed

PrYSM - RICE Inquiry Form

Immigration History

Criminal History