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Legal Service Provider Directory Application

Fill out this form to register as a legal service provider in FAIRRE's & CIRC's legal directories.

Office/ Organization Name

I am applying as a...

The following contact info is stored internally and is not shared in the referral process

First Name

Email

Last Name

Phone Number

Website

Office Locations

Service State #1

Service State #2

Service State #3

Office/ Organization Logo or Attorney Headshot

Select File

What are your consult & retainer fees? (If any)

Select all services you provide

AsylumRemoval Deportation DefenseAdjustment of StatusNaturalizationDACAWork Permit AuthorizationFamily-based PetitionsGreen Card RenewalsSIJSNon-Immigrant VisasVictim Related VisasOther

If you selected other, please describe the other services you provide

Preferred method of contact for client referrals *

Call our office number

Send us an email

Fill out our contact form

Add relevant contact information here

What languages are spoken at your office? * Obligatorio

English

Spanish

Other

Include other languages here

Would you be willing to offer free consultations or discounted rates for clients referred to you by CIRC or FAIRRE? *

Yes, I'd like to schedule a meeting to discuss this

No

Check here if your organization is a part of AILA.

You agree that your office/ organization is currently accepting new cases and will notify FAIRRE if said office/ organization is no longer accepting cases.

You agree that all information contained in this application will be accessed by both FAIRRE and CIRC to be shared on their 1) legal directories and/ or 2) contact referral list(s).

Your submission has been received. A FAIRRE representative will review your information and be in contact to finalize your profile. Thank you!

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Correo Electronico: Marialopeznotary@gmail.com

Telefono: (720) 773-2337

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Denver, Colorado 80202

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