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Chicago TPS and EAD Workshop Registration

This form was created by The Resurrection Project (TRP), a nonprofit organization in Chicago that helps immigrants navigate the immigration system, in collaboration with other immigrant-serving nonprofits. This form is intended for immigrants living in Illinois who arrived in the United States and are considering applying for Temporary Protected Status (TPS) or a work permit (EAD). By completing this form, you may be invited to participate in a workshop to complete your TPS or EAD application.

You must complete ONE form per family unit. You will be asked to include names and information for anyone else in your family who is interested in applying for an immigration benefit.

After completing this form, TRP will verify with the city and/or state that you have received government-funded housing in order to participate. Within 1-2 weeks, if you are deemed eligible to participate, TRP will send you a link to register to attend a workshop.

Form Type:

Part 1: Individual Completing this Form

If applicable, name of individual assisting me to complete this form

If applicable, email address of individual assisting me to complete this form

If applicable, association of individual assisting me to complete this form

PLEASE READ BEFORE COMPLETING THIS FORM:

By checking this box, I understand that if I am selected for an application preparation workshop, I will not be given an attorney or DOJ-accredited representative to represent me in my case, but an attorney or DOJ-accredited representative will assist me in correctly filing my application.

By checking this box, I acknowledge that this form is designed to help me decide if I should attend an upcoming immigration application preparation workshop. The person that is helping me fill out this form is not authorized to provide me with legal advice. This form does not confirm my eligibility for an immigration benefit and I should seek legal consultation at a workshop or with a trusted legal service provider to verify my eligibility.  

By checking this box, I acknowledge I am not guaranteed a spot in a workshop.

By checking this box, I understand that completing this form does not create an attorney-client relationship between me and TRP or any other legal service provider. Nothing in this form should be considered legal advice.

By checking this box, I understand that I authorize TRP to share limited information with legal service providers and government agencies in relation to my immigration application.

By checking this box, I confirm that I have watched the following Know Your Rights video before continuing with this form.

Part 2: Applicant Contact Information

First Name

Middle Name

Last Name

Select the appropriate option regarding your housing situation:

I am currently receiving state-funded rental assistance thorough the ASERAP program
I previously received state-funded rental assistance through the ASERAP programI am currently residing in a shelterI previously resided in a shelterI previously resided at a Police Station

ASERAP Number (listed on rental agreement, is 7 digits and starts with 100). If you do not have it currently, you will receive a request to provide it before your application is reviewed.

Shelter Request (SR) Number: This is a ten digit number that was assigned to your request for shelter with this format: SR#XX-XXXXXXXX. If you do not have it currently, you will receive a request to provide it before your application is reviewed.

Date you began receiving rental assistance

Month and year you began residing in shelter

Month and year you began residing at station

Month and year you left shelter

Month and year you left station

Name of Shelter

Other Shelter Name

Station Name or Address

How can we contact you?

Mobile PhoneEmailMobile Phone and Email

Mobile Phone Number

Preferred Language

Other Language

Date of Birth

Street Address

Country

City

State

Zip Code

Date arrived to the U.S

A-Number (A-Number is the 8 or 9 digit number that you can find on your immigration paperwork. It is usually labeled “A#” or “File No.” and posted prominently near the top of any immigration paperwork)

A-

Family Members

List information for every family member that is residing with you AND that will be applying for an immigration benefit with you:

Family Member 2

First Name

Last Name

Date of Birth

Country of Birth

A-Number

A-

Add another family member

Family Member 3

First Name

Last Name

Date of Birth

Country of Birth

A-Number

A-

Add another family member

Family Member 4

First Name

Last Name

Date of Birth

Country of Birth

A-Number

A-

Add another family member

Family Member 5

First Name

Last Name

Date of Birth

Country of Birth

A-Number

A-

Add another family member

Family Member 6

First Name

Last Name

Date of Birth

Country of Birth

A-Number

A-

Add another family member

Family Member 7

First Name

Last Name

Date of Birth

Country of Birth

A-Number

A-

Add another family member

Family Member 8

First Name

Last Name

Date of Birth

Country of Birth

A-Number

A-

Add another family member

Family Member 9

First Name

Last Name

Date of Birth

Country of Birth

A-Number

A-

Add another family member

Family Member 10

First Name

Last Name

Date of Birth

Country of Birth

A-Number

A-

The following questions may help us determine if you are eligible for any other immigration benefits. If you answer yes to any of the questions, reach out to a legal service provider for a more in-depth consultation.

Has anyone ever physically, emotionally, sexually, or economically hurt you or threatened to hurt you?

YesNo

Have you ever been the victim of any crime that you reported to the police or another government agency?

YesNo

Were you harmed or threatened with harm in your country or on your journey from your country to the US?

YesNo

You appear eligible to attend an immigration application workshop to apply for TPS and/or EAD. Prior to signing up for a workshop date, TRP will verify with the city and/or state to ensure you are currently or in the past resided in city or state-funded care. If you are eligible, within 1-2 weeks you will receive a link to register for an upcoming workshop to prepare your application.

Unfortunately, you do not appear to be eligible for TPS at this time. Please continue with Part 5: Eligibility for Employment Authorization Document.

Part 5: Eligibility for Employment Authorization Document (EAD)

Employment Authorization Documents (EADs) are work permits. There are many ways to qualify for an EAD. Many southern border arrivals who are processed by Customs and Border Protection (CBP) are given parole and allowed to lawfully enter the United States. Depending on the type of parole, an individual may be eligible to apply for an EAD.

Do you currently have parole?

YesNo

Does your parole expire 90 days or more in the future? Review parole documentation instructions for more information

YesNo

Have you submitted an application for asylum (I-589) to U.S. Citizenship & Immigration Services (USCIS) or the Executive Office for Immigration Review (EOIR, Immigration Court)?

YesNo

Did you submit your application for asylum MORE THAN 150 days ago?

YesNo

You appear eligible to attend an immigration application workshop to apply for EAD. Prior to signing up for a workshop date, TRP will verify with the city and/or state to ensure you are currently or in the past resided in city or state-funded care. If you are eligible, within 1-2 weeks you will receive a link to register for an upcoming workshop to prepare your application.

Unfortunately, you do not appear to be eligible for an immigration application workshop at this time. Consult with a legal service provider if you believe you may be eligible for another immigration benefit or if you are interested in seeking asylum.