DACA Scholarship Program Application | Tri-Cities Immigration Coalition

Send a paragraph to TCIC expressing the applicant’s need for assistance with the fee to reapply for DACA status.

Applicant Name | Nombre del solicitante

First

Last

Applicant Email | Correo electrónico del solicitante

Applicant Phone Number (in case there are questions) | Número de teléfono del solicitante (en caso de preguntas)

Applicant Mailing Address | Dirección postal del solicitante

Address Line 1

Address Line 2

City

State

Zip Code

del to Dirección

Paragraph to TCIC expressing need for assistance with the fee to reapply for DACA status | Párrafo a TCIC expresando la necesidad de asistencia con la tarifa para volver a solicitar el estatus DACA

Copy of EAD card with the ID# blocked out (confidentiality) | Copia de la tarjeta EAD con el ID# bloqueado (confidencialidad)

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Copy of the completed application without the EAD number | Copia de la solicitud completada sin el número EAD

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Have you already paid the DACA reapplication fee? | ¿Ya pagó la tarifa para volver a solicitar DACA?

Yes | Sí
No | No

If you've already paid, upload the receipt of payment so we may reimburse you | Si ya pagó, cargue el recibo de pago para que podamos reembolsarle

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Additional application information (optional notes to the DACA Scholarship committee) | Información adicional de la solicitud (notas opcionales para el comité de Becas DACA)