Citizenship Intake Questionnaire

To qualify for and enroll in services provided by ACCS Adult Education programs, you must be either a US citizen or permanent resident, or you must be lawfully present in the United States. You will be asked to provide documentation as proof of your status.

STOP

If you do not meet the criteria above, you are not eligible for adult education services through ACCS Adult Education programs. There is no need to complete these forms.

Name

First Last

Date of Birth

MM slash DD slash YYYY

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

1. Are you a citizen of the United States?(Required)

US Citizen

Permanent Resident

Lawfully Present in the US

If you are a US citizen, complete item 2a.
If you are not a US citizen, complete item 2b.

2a. If you are a US citizen, in what US state or territory were you born?

2b. If you are a permanent resident or are lawfully present in the US, in what country were you born?

3. What form(s) of identification can you provide as proof of citizenship or legal status?(Required)

Real I.D.

U.S. Birth Certificate

U.S. Passport

Fed. DHS- issued documentation

Certificate of U.S. Citizenship or Naturalization

Alabama Voter Registration Identification

SNAP/TANF Identification Card

Other

If you selected "Other" above, please list the type of documentation you can provide.

Once you click "Submit" you may have to wait up to a full minute for the next screen to appear. Your patience is appreciated.

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