Seckin Law Firm would like to help you realize your immigration objectives. This form must be completed before Ms. Seckin can schedule a telephone consultation with you. The information submitted with this form will be kept strictly confidential. Once Ms. Seckin reviews your completed form, we will e-mail you to schedule a consultation.

Immigration Objectives
Briefly describe your case and what you would like us to do for you:
(*) = required fields.

Contact Information :
email : *
Name : *
Middle Name :
Family Name:*
Marital Status :	Single Maried Divorced Other

Current Address :
Street & Apt. No :
City :
State :
Zip Code :
Home Phone :
Business Phone :
Cell Phone : *
How we way to contact :	email Home Phone Business Phone Cell Phone

Current Employment :
Name of Employer :
Current Occupation :
Highest Level of Education :

Immigration Details :
Country of Birth :
Currrent Immigration Status if in US* (ie: H-1B, L-1, J-1, O-1, not in country, etc.) :
Status Expiration Date :

Other :

How did you hear about Seckin Law Firm? Please be specific.

I understand that submitting this form does not create an client-attorney relationship between myself and Ms. Vanessa V. Seckin, and thus, Ms. Seckin is not obligated to schedule a consultation with me.