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United States Congressman
Jim
Baird
Proudly Serving Indiana's 4th District
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Evacuating Afghanistan
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Identifying Information
(of person seeking to leave Afghanistan)
Prefix:
First Name:
*
Middle:
Last Name:
*
Age:
*
Citizenship:
*
Date of Birth:
*
Supporting Information
(of person seeking to leave Afghanistan)
Current Citizenship Status:
--- Please Select One ---
American Citizen
LPR (Green Card Holder)
Currently holding a SIV
Currently in the SIV process but does not yet have a SIV
Has been referred to the US refugee admissions program through a P1/P2 referral
If they were referred to the USRAP, please indicate what government agency or US Media/US NGO referred them:
Connection to the United States (where applicable):
Current location and mobility:
Contact information (including email, messaging abilities, etc.):
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