QUESTIONAIRE – The Law Library

IMMIGRATION HELP ORG

LANDESTOY SRL

Personal Information

What is your full name? *

Date of birth *

Address

Phone *

Email *

Family Information

Are you married ?

Yes No

If yes:

- What is your spouse's name?

- What is your spouse's date of birth ?

- In which city and country was your spouse born ?

- When and in which city/country did you get married ?

Do you have children ?

Yes No

If yes:

- Please provide the names, dates of birth, and birthplaces (city and country)for each of your children ?

Residency and Travel Information

When did you leave your home country ?

When did you arrive in your current country of residence ?

What address did you live at before leaving your home country?

How long did you live there ?

Education and Employment

What schools, colleges, or universities did you attend? Please list the names, locations, and years of attendance.

What jobs have you held? Provide the names of the employers, locations, and years worked.

Family Background

What are your parents' names and birthplaces (city and country)?

Do you have siblings ?

Yes No

If yes, provide their names, birthplaces, and current addresses.

Safety and Concerns

Are you afraid to return to your home country ?

Yes No

If yes:

- Who are you afraid of?

- Why are you afraid to return?

Have you experienced threats or harm? Please provide specific details, including dates and incidents.

Did you file any police reports or visit a hospital due to these threats? If so, please provide copies of the reports or medical records.

Documentation

Do you have a passport or any other form of identification? Please provide a copy.

Thank you. Your information has been submitted someone from our staff will contact you as soon as possibe.

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