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Immigrant Development Center
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Client Intake Form
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Female
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English
Somali / Soomaali
Arabic / العربية
Swahili / Kiswahili
Spanish / Español
Nepali / नेपाली
Kurdish / Kurdî
French / Français
North Dakota
Minnesota
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District of Columbia
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Massachusetts
Michigan
Mississippi
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Montana
Nebraska
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New Hampshire
New Jersey
New Mexico
New York
North Carolina
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
$
Employed full time
Employed part time
Self-employed or business owner
Not working, looking for work
Not working, not looking for work
Student
Retired
Unable to work
Restaurant or food service
Grocery or retail store
Transportation or trucking
Childcare
Home health or personal care
Cleaning services
Construction or trades
Beauty or barber services
Auto repair
Professional or office services
Technology
Manufacturing
Agriculture
Not registered yet
Sole proprietorship
Partnership
LLC
Corporation
Nonprofit
North Dakota
Minnesota
Another state
$
$
$
Equipment
Inventory
Vehicle
Building or rent
Working capital
Starting a new business
Paying other debt
12 months (1 year)
24 months (2 years)
36 months (3 years)
60 months (5 years)
84 months (7 years)
120 months (10 years)
$
No credit history yet
Poor
Fair
Good
Excellent
I have not applied before
No formal schooling
Primary school
Some high school
High school diploma or GED
Trade or technical certificate
Some college
Associate degree
Bachelor's degree
Master's degree or higher
Beginner — a few words
Basic — simple conversations
Intermediate — most daily conversations
Advanced — comfortable at work
$
Manufacturing or warehouse
Healthcare
Trucking or delivery
Food service
Retail or customer service
Construction or trades
Childcare or education
Office or administration
Technology
Cleaning or janitorial
Full time
Part time
Either one
I have one but it needs updating
Getting to work
Childcare
English language
Computer skills
Work schedule
Health
My credentials are not recognized here
I do not have a license or permit
I have a learner permit
I have a U.S. driver's license
I have a license from another country
My license is suspended
Not yet
I am studying for it now
I took it but did not pass
I own a vehicle
I can borrow one
I do not have a vehicle
Help studying for the written test
Driving practice
Interpreter at the licensing office
Understanding car insurance
Buying a car
Getting to work or appointments
Smartphone
Laptop
Desktop computer
Tablet
None of these
Internet at home
Phone data only
Public wifi only (library, community center)
No reliable internet
Beginner — I need help turning things on and getting started
Some experience — I can use a phone but not a computer
Comfortable — I use email and websites
Advanced — I want to learn specific software
Email
Online job applications
Writing documents
Spreadsheets
Online banking
Social media for business
Staying safe online
Government websites and forms
Immigration paperwork
Citizenship or naturalization
Family reunification
Work authorization
Housing or landlord issue
Employment issue
Business legal question
I have a deadline or court date soon
Within a few months
No deadline, just planning ahead
Housing
Food
Healthcare
Childcare
Enrolling children in school
English classes
Interpretation or translation
Help with rent or utilities
Understanding a letter or form
This is urgent
In the next few weeks
Not urgent
Business basics
Writing a business plan
Bookkeeping
Taxes
Marketing
Food safety
Credit and banking
Job readiness
In person
Online
Either one
Weekday mornings
Weekday afternoons
Weekday evenings
Weekends
Friend or family
Existing IDC client
Community organization
Social media
Website
Event
Government agency
School or college
Employer
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