LGBT Asylum Task Force - Supporting New Beginnings

Upload a copy of your passport if available.

Do you have a US visa? *

Yes

No

Are you in a safe location? *

Yes

No

Email: *

Please upload any evidence that can support your story.

Name: *

Have you received a Covid-19 vaccine? *

Yes

No

Nationality: *

Date of Birth: *

What is your current housing situation? How much longer can you stay there?

Current Location

How did you hear about us?

Please share an outline of your story with us. *

Phone

Please upload any evidence that can support your story.

Intake Application Form