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The NewHip Registration Form
Welcome to the New Housing Initiative Project! We are here to understand your needs and guide you.
Kindly complete this form to the best of your ability, and we'll assess your eligibility for our programs.
* Indicates required question
Email
*
Record my email address with my response
Basic Information
What is your name?
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Your answer
Are you traveling with child/ren?
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Yes
No
Required
How many child/ren?
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Your answer
Are all family members accounted for and safe?
*
Yes
No
Where are you originally from?
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Your answer
How long have you been in the United States?
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Your answer
What is your A-Number?
Your answer
Have you applied for a EAD or working permit?
*
Yes
No
Required
Immediate Needs
Do you need assistance with finding housing?
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Yes
No
Do you need help finding healthcare services?
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Yes
No
Education and Employment
Do you or your children need help enrolling in school?
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Yes
No
Are you or any family members looking for employment opportunities?
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Yes
No
Language and Communication
What language(s) do you speak?
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Your answer
Do you need assistance with English?
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Yes
No
Future Plans and Aspirations
What are your hopes and plans for the future here in the U.S.?
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Your answer
Immediate Concerns and Questions
Do you have any immediate concerns or questions that you would like to discuss?
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Your answer
Is there anything else you need assistance with right now?
*
Your answer
Thank You! We will promptly reach out to you.
A copy of your responses will be emailed to .
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