Haiti TPS Interest Survey
Thank you for expressing your interest in applying for Temporary Protected Status (TPS) with CASA. Please fill out the following survey if you are from Haiti and are interested in applying for TPS. Please note, filling out this survey does not guarantee that CASA will represent you in your TPS case. We will reach out to you either by phone or email to further discuss the details of your case to determine your eligibility for TPS, and either offer legal representation or provide you a referral to another trusted organization that can help you.
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Email *
First Name *
Last Name *
Phone Number *
Address *
State *
Zip Code *
Email *
Date of Birth *
Country of Origin *
Please explain if you chose "Other" for the previous question.
Are you a citizen of any other country besides the country listed above? *
Approximate date of entry date into the United States *
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/
DD
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How did you enter the United States? *
Please explain if you chose "Other" for the previous question.
Were you present in the United States on July 29, 2021? *
Have you had any contact with the police or received any tickets? *
Please explain if you have had contact with the police.
Have you had any contact with immigration or been to immigration court? If yes, please explain below. *
Please explain if you have had contact with immigration
Have you applied for any other form of immigration relief (like asylum) in the United States? If yes, please explain below. *
Please explain if you have applied for any other form of immigration relief.
Do you have an attorney helping with your case?
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