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Venezuelan Immigration Clinic Registration Form
Information session with lawyers, Friday, January 26, 2024 (10:00am - 12:00pm)
TPS application clinic with lawyer Friday, February 2nd, 2024 by appointment only.
Name:
*
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Mobile Number
*
Format: (000) 000-0000.
Are you a Venezuelan citizen?
*
Please Select
Yes
No
If you are not a Venezuelan citizen are your parents Venezuelan citizens?
*
Please Select
Yes
No
Do you have TPS?
*
Please Select
Yes
No
When does it expire?
-
Day
-
Month
Year
Date
Including yourself, how many people on your family want to apply for TPS?
*
What date did you enter the United States?
-
Day
-
Month
Year
Date
Please confirm the following:
*
I understand it is required to attend a mandatory information session that will be on January 26, 2024 at 10:00am
I understand the information session will last for approximately 2 hours.
I understand that the US government will charge between $50.00 and $545.00 for the TPS.
I am aware that the clinic to complete TPS application will be on February 2, 2024 and it is required to attend to the information session on January 26, 2024.
Signature
Submit
Should be Empty: