NKY Legal Intake and Consultation Request Form

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Use this form to provide key information for the Legal Department of Kentucky Refugee Ministries-Covington to review. A representative from our office will contact you about the form. Your submission of the Request Form does not constitute a promise, guarantee, or retainment of legal services from our office.

Name(Required)

First Last

Phone(Required)

Email(Required)

Enter Email Confirm Email

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Birth(Required)

Length of Time in United States(Required)

Home Country(Required)

Residence in Another Country?(Required)

Language(s) Spoken(Required)

English

Spanish

French

Arabic

Other (Specify Below)

Specify Other Spoken Language

How were you referred to us?(Required)

Have you worked with an attorney on this case?(Required)

Who was the attorney?(Required)

Marital Status(Required)

Spouse Name(Required)

Date of Marriage(Required)

Is your spouse in the United States?(Required)

Is your spouse in the US?(Required)

Do you have children?(Required)

Total Number of Children(Required)

Are the children in the United States(Required)

List children's ages(Required)

Children's Names(Required)

U.S. Entry Date(s)(Required)

Place of Entry(Required)

Did you enter with a Visa?(Required)

What type of Visa did you enter on?(Required)

I.E. Visitor or Student

Visa expiration date(Required)

Were you detained by immigration officials(Required)

Ex. ICE, CBP, etc.

What is your Alien Registration ("A" or USCIS) Number?(Required)

Put N/A if none

Spouse Alien Registration Number(Required)

Put N/A if none

Children's Alien Registration Numbers(Required)

Put N/A if none

Are you currently in deportation proceedings/immigration court?(Required)

Court Location(Required)

Put N/A if none

Hearing Date(Required)

Put N/A if none

Have you ever filed any immigration applications?(Required)

List Application(s)(Required)

Reason for Legal Consultation Request(Required)

Other Consultation Request (Specify)

Notes:

Supporting Documents Requested(Required)

Use ctrl + right click on Windows/PC to select multiple supporting documents requested.

Previous Addresses for last two years(Required)

If a KRM Staff member helped complete this form, list their name

Phone

This field is for validation purposes and should be left unchanged.

Join the journey. Become a KRM Partner today.

NKY Legal Intake and Consultation Request Form

Join the journey.
Become a KRM Partner today.