Winningham, Stein & Basey

*Is this form being completed by the alien seeking consultation? 

If no, please complete the Filer Information section.
If yes, begin at the Alien Information section.

Filer Information
Relationship to Alien:
Email Address:
Mailing Address:
Alien Information
*Ever been in the United States?
If yes, please stop and click here to access the form you need to complete.
  *Residence Abroad
  US Mailing Address (if any)


*Telephone Number(s)


*Date of Birth (MM/DD/YY):
*City and Country of Birth:
*Present Citizenship (Country):
*Mother born in US or US Citizen?:
*Father born in US or US Citizen?:
Any grandparents born in the US?

Highest level of education completed:

Alien or spouse ever served in any United States military forces?
Current and prior occupations:
Names of children, their ages and countries of birth:
*Marital Status:
  If married...
Spouse's Name:
Spouse's Citizenship:
Spouse's Country of Birth:
*Ever applied for permanent residence in the United States?
If yes, date and place applied:
*How did you find out about us? Please be specific ('My friend John Smith', 'Google', etc.).
*Describe the immigration problem or desired new Visa/Status:
Have you previously paid someone else for a consultation concerning this immigration matter?
If yes, who? (Please provide name, location, and the immigration benefit(s) or results they said they could obtain):

 *E-mail Address:

(If you would like a copy of this completed form, please print one now.)

By clicking the Submit button, you affirm that you understand this information is provided only for the purpose of requesting a consultation and is not intended to establish an attorney client relationship.

Having problems submitting this form? Please call (405) 843-1037.