Interest Form for the Mexican Screening Project

Introduction and Instructions

The purpose of this survey is for CLINIC affiliates to indicate their interest in participating in a funded, Mexican Screening Project (described below) and ask for a Memorandum of Understanding to review and sign if participation is definite.

Mexican Screening Project
Pilot projects and demographic studies conducted by CLINIC suggests that potentially 18 percent of unauthorized immigrants, or more than one million people across the United States, may be eligible for a benefit leading to lawful permanent residence. To expand on these pilot project results, CLINIC is launching a Mexican Screening Project using funding from the Mexican Consulate in Atlanta. Funding is open to any qualified affiliate in CLINIC’s network. You may participate even if you currently have funding for this work provided that unduplicated numbers are reported.

The purposes of the project are to:

Screen and identify Mexican nationals who are unauthorized immigrants with potential eligibility for an immigration benefit (both affirmative and defensive)
Screen Mexican nationals who have LPR status and are potentially eligible to naturalize
Provide Know Your Rights information and materials to said Mexican nationals
Collect and submit key data points, and copies of identification about screened individuals to CLINIC, and in turn to the Mexican Consulate

In the past, CLINIC has been able to pay $75 for each completed and documented screening. CLINIC is seeking the same amount for this year's funding, pending confirmation from the funder.

The project will end on December 31, 2019. Affiliates can enroll anytime between the project’s official launch date of June 26, 2019 and November 1, 2019, by signing a Memorandum of Understanding during that time frame. It is hoped that the project will be extended for 2020.

If you have questions or want to learn more, contact your CLINIC Field Support Coordinator, Jeff Chenoweth at jchenoweth@cliniclegal.org, or Laura Nino-Berry at lnino@cliniclegal.org.

1. Who is completing this survey? *This question is required.

First Name

Last Name

Email Address This question requires a valid email address.

Phone Number This question requires a valid number format.

Organization

City

State

2. Are you the immigration program director? *This question is required.

3. Who is the immigration program director? *This question is required.

First Name

Last Name

Email Address This question requires a valid email address.

Phone Number

3. What date do you anticipate being able to complete and sign a Memorandum of Understanding with CLINIC, thereby beginning your organization's participation in the project? *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

4. Please estimate the number of legal screenings for Mexican nationals that your organization will be able to complete and document by December 31, 2019. Please note that the estimated number is not binding, and that your organization will be paid according to the actual number of screenings completed and documented.

*This question is required. This question requires a valid number format.