IMMIGRATION INTAKE QUESTIONNAIRE NAME: PHONE: EMAIL: ADDRESS: BEST TIME TO CONTACT: SECTION 1 WERE YOU BORN AFTER JUNE 15, 1981? IF YES, WHAT DATE? DID YOU COME TO THE UNITED STATES BEFORE YOUR 16TH BIRTHDAY? HAVE YOU CONTINUOUSLY RESIDED IN TH UNITED STATES SINCE JUNE 15, 2012? WERE YOU PHYSICALLY PRESENT IN TH UNITED STATES ON JUNE 15, 2012? ARE YOU CURRENTLY PHYSICALLY PRESENT IN THE UNITED STATES? DID YOU ENTER THE UNITED STATES WITHOUT INSPECTION BEFORE JUNE 15, 2012 OR LOSE YOUR LAWFUL STATUS AS OF JUNE 15, 2012? ARE YOU CURRENTLY IN SCHOOL, HAVE GRADUATED OR OBTAINED A CERTIFICATE OF COMPLETION FROM HIGH SCHOOL, HAVE OBTAINED A GED CERTIFICATE, OR ARE AN HONORABLY DISCHARGED VETERAN OF THE COAST GUARD OF ARMED FORCES OF THE UNITED STATS? HAVE YOU BEEN CONVICTED OF A FELONY OR MISDEMEANOR? SECTION 2 WHEN WAS THE FIRST TIME YOU ENTERED THE UNITED STATES? WHEN WAS THE MOST RECENT TIME THAT YOU ENTERED THE UNITE STATES? ARE YOU MARRIED? IF YES, IS YOUR SPOUSE A: U.S.CITIZEN, LAWFUL PERMANENT RESIDENT OR NONE OF THE ABOVE? DO YOU HAVE ANY CHILDREN OR STEP-CHILDREN? IF YES, PLEASE LIST CHILDREN: NAME, DATE OF BIRTH, AND PLACE OF BIRTH. IS YOUR MOTHER A: U.S.CITIZEN, LAWFUL PERMANENT RESIDENT, OR NONE OF THE ABOVE? IS YOUR FATHER A: U.S.CITIZEN, LAWFUL PERMANENT RESIDENT, OR NONE OF THE ABOVE? ANY OF YOUR SISTER A: U.S.CITIZEN, LAWFUL PERMANENT RESIDENT, OR NONE OF THE ABOVE? ANY OF YOUR BROTHER A: U.S.CITIZEN, LAWFUL PERMANENT RESIDENT, OR NONE OF THE ABOVE? HAS ANY IMMIGRATION PETITION EVER BEEN FILED FOR YOU OR YOUR PARENTS? HAVE YOU EVER BEEN DEPORTED FROM THE U.S.? COMMENTS: