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* 1. Name of your organization

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* 2. Location of your organization

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* 3. What is your affiliation with CLINIC?

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* 4. Estimated number of DACA applicants your organization served last year (2015)

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* 5. On a scale of 1-5 (1 being extremely clear; 5 being poor), please rank the:

  Extremely Clear Mostly Clear Fair Not Very Clear Poor
Clarity of the questions found on USCIS Form I-821D
Clarity of the instructions for USCIS Form I-821D
Clarity of the public facing guidance about DACA on USCIS.gov

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* 6. What parts of Form I-821D do you find confusing or in need of improvement?

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* 7. What additional data could be collected on Form I-821D that would assist USCIS in making its determination?

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* 8. How could the Instructions to Form I-821D be improved?

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* 9. For clients that are challenged in applying for DACA, what barriers are most significant?

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* 10. With respect to the DACA application process, what recommendations to you have to make the program more accessible and successful?

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* 11. May we contact you?

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