DACA Individual Questionnaire

    Personal Information Top ↑
    Entries to the U.S.

    Please provide the following information for each entry into the U.S. For your first entry, please indicate:

    (e.g. entry without inspection, B-2 Tourist Visa, F-1 student, etc.)

    For your second entry into the U.S., please indicate:

    Acceptable filetypes are .pdf, .doc/.docx, .jpg/.jpeg, .gif, .png, and .webp. You up upload up to 7 documents.
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    Please list your dates of application, approval, and expiration for each period of DACA which you have been granted. If your DACA application has ever been denied, please list the date of application and date of decision.

    First validity Period:

    Second validity Period:

    Third validity Period:

    Fourth validity Period:

    Fifth validity Period:

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    Miscellaneous Questions

    Are you currently married or engaged?

    What is your partner's/spouse’s immigration status?

    Do you plan on getting engaged or married in the near future?

    Do you have any children who were born in the United States?

    Have you ever been the victim of a crime in the United States?

    Have you ever been a victim of domestic abuse?

    Are you the spouse or child of a current or former member of the U.S. military?

    Did a family member or employer ever file a petition on behalf of one of your parents on or before April 30, 2001?

    Was it before January 14, 1998?

    Do you have a copy of the Receipt Notice or Department of Labor Certification?

    Were you present in the United States on December 21, 2000?

    Did either of your parents ever apply for any immigration relief, including—but not limited to—asylum?

    Do you fear returning to your country of origin?

    Is it because of something about yourself which you cannot or should not change (e.g. religion or sexual orientation?)

    Please provide a brief explanation:

    Do you have a degree in the healthcare field?

    Do you have an employer that participates in employment visa sponsorship?

    Have you and your employer discussed the possibility of sponsorship?

    Is your employer a nonprofit organization doing research in the field of education?

    Is your employer a university or institution of higher education?

    Do you have any religious training, ordination, or qualifications to engage in a religious vocation?

    Have you ever been in immigration court proceedings?

    Have your parents ever been in immigration court proceedings?

    Have you ever used any documents that were not yours or that were altered or falsified for purposes of entry to the United States?

    Have you ever said you were a United States citizen in writing or otherwise?

    Have you ever registered to vote or voted in a U.S. election (including any local, state, or federal election)?

    Have you ever been arrested, cited, or detained by law enforcement authorities for any reason even if the charges were dismissed, expunged, or traffic related?

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