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Request for Information

All information you provide will remain confidential and protected by law. Building One Community does not share any information you provide with immigration authorities or law enforcement.

Name(Required)

First Middle Last

Second Last Name

Mobile Phone(Required)

What is the best way of contacting you?(Required)

Text Message

Phone Call

Are you inquiring for yourself or on behalf of someone else?

Myself

Someone else

Country of Origin(Required)

Check all boxes that apply to you:(Required)

I was detained at the border and released.

I have a case in immigration court.

I may have missed my immigration court date.

I have to check in with ICE.

I am an Unaccompanied Minor (UAC) released to a sponsor.

None of the above applies to me.

A-Number / Alien Registration Number

A-Number / Alien Registration Number(Required)

I was detained at the border and released and entered on:

MM slash DD slash YYYY

I entered with a CBPOne appointment at the U.S. southern border.(Required)

YES

I entered with a CBPOne appointment at the U.S. southern border and I entered on:

MM slash DD slash YYYY

I have a case in immigration court:(Required)

in Hartford

another court

Upcoming Court Date

MM slash DD slash YYYY

Notice to Appear Date

MM slash DD slash YYYY

The court date was in the past year.(Required)

Yes

Birthdate(Required)

MM slash DD slash YYYY

Further questions about your situation:

You do not have to answer these sensitive questions, but your answers will be helpful for our attorneys when they review your information to determine whether they may be able to provide a consultation. You can check one or more boxes:

A family member has been arrested and detained by ICE during or after a criminal case.

I am wearing an ankle monitoring bracelet and must appear before an asylum office for a Credible Fear Interview (CFI)

I have [and/or a family member has] experienced physical, emotional, sexual, psychological, and/or financial harm in the United States.

I am being forced to work or perform sex work against my will with the use of violence, threats, lies, false promises and/or other forms of coercion.

I am seeking assistance to file an initial application for Temporary Protected Status (TPS) for Afghanistan, Burma (Myanmar), Cameroon, Haiti, Syria, Somalia, South Sudan, Venezuela, or Yemen.

I am interested in applying for immigration benefits for myself or my family, and I am not in immigration court:(Required)

I am the victim of a serious crime or domestic violence in the U.S.

I am a permanent resident and want to naturalize

I am a citizen or permanent resident and I want to petition for a relative to get a Green Card

I am seeking assistance or information about a different immigration issue for myself or a family member.

Please provide any information that can be helpful.

Please provide additional information that may be helpful.(Required)

Hidden

Completed by ILS Staff

Marks if the form was filled in by ILS staff or ILS staff assisted with filling out the form.

Building One Community is a 501(c)(3) nonprofit organization. Contributions are tax deductible to the extent allowed by law.

CONTACT US
VISIT US
JOB OPPORTUNITIES
HELPFUL RESOURCES
VOLUNTEER MANUAL
PHOTOGRAPHY & VIDEO POLICY
PRIVACY POLICY
TERMS OF USE

Stay in touch:

NEWSLETTERS

Building One Community is a 501(c)(3) nonprofit organization. Contributions are tax deductible to the extent allowed by law.

CONTACT US
VISIT US
JOB OPPORTUNITIES
HELPFUL RESOURCES
VOLUNTEER MANUAL
PHOTOGRAPHY & VIDEO POLICY
PRIVACY POLICY
TERMS OF USE

Stay in touch:

NEWSLETTERS

Request for Information

• Annual Report 2022

• Form 990

• Audited Financial Statements 2022

Stay in touch:

• Annual Report 2023

• Form 990

• Audited Financial Statements 2023

Stay in touch: