Client - Name(Required) First Last Client - InfusionSoft Email(Required) Date(Required) MM slash DD slash YYYY Your Name(Required)Select Your Name *AlejandraByrdieCynthiaLupitaMaferName of Person Placing the Call(Required) First Last Is this an Employment Case?(Required) Yes No Are they currently living in the US.?(Required) No Yes - Less than 1 year Yes - Greater than 1 year If more than 1 yr illegally – Select Family Consult from case type. If "No" or less than 1 year - Select either Employee or Employer from case typeReferral List(Required)Select Type *TBDTBDTBDTBDTBDTBDU-VisaAll OtherLanguage for future communications(Required)Select Language *EnglishSpanishName of Employer(Required) First Last Phone (Employer)(Required)Employer - Email(Required) Address (Employer)(Required) Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zip Code Employer - Are you currently living in the US?(Required) Yes No Employer - Under what immigration status?(Required) Employer - Do you currently own/run a company outside the US?(Required) Yes No Employer - If yes how many employees?, which country?(Required)Employer - Do you know the amount to invest or have invested in the US business?(Required) Yes No Employer - If Yes what amount?(Required) Employer - Are you looking to become a legal permanent resident?(Required) Yes No Employer - Are you planning to bring your family to the US?(Required) Yes No Employer - If yes, number of members and ages?(Required)Employer - Have you had any Immigration problems?(Required) Yes No Employer - Immigration Problem Details(Required)Please describe What, When & Where for the immigration problem(s) for this employerEmployer - Have you had any Criminal Issues anywhere (arrest, charges, courts,etc)?(Required) Yes No Employer - Criminal Issue Details(Required)Please describe What, When & Where for the criminal details of this employeeEmployer - At the end of the consultation what do you expect to accomplish?(Required)NameThis field is for validation purposes and should be left unchanged.