Credit Card Authorization Form
Prospective Clients
We like to talk to all new clients personally. If you do not have an appointment for a telephone consultation or an office appointment, please complete the form below. You should receive a reply within a few hours. Alternatively, to schedule an appointment please call Debbie on (212) 840-3878, or send an email to debbie@perlitsh.com.
Do you currently reside in the United States?
If YES, what is your current visa status?
Please provide a brief description of the issue you wish to discuss.
Please let us know how to get in touch with you:
Name:
E-mail:
Cell / Pager Number:
If you have been assigned a username and password and have been asked to complete our online Immigration Tracker™ questionnaire, please log in by clicking below.
If you have made an appointment for a consultation and have been asked to complete the credit card authorization form, please click here.
49 West 45th Street
6th Floor
New York, NY 10036
Tel: (212) 840-3878
Fax: (917) 510-0872
office@perlitsh.com
© 2006 Stephen M. Perlitsh, P.C.