# Register for a Civics and Citizenship Toolkit

OMB No. 1615-0120; Expires 12/31/2020

## Register for a Free Copy of the Civics and Citizenship Toolkit

Additional Toolkits may be purchased from the U.S. Government Bookstore.

### Eligibility Requirements

                - All eligible organizations must register to receive a free copy of the Toolkit.
                - Registration is limited to immigrant-serving organizations in the United States only.

### Examples of eligible organizations include:

                - Community-based organizations or nongovernmental organizations that work with immigrants
                - K-12 schools, adult education centers, community colleges, universities, and other educational institutions
                - Ethnic or home country organizations
                - Libraries: K-12, public, academic, etc.
                - Faith-based organizations
                - Volunteer groups
                - Civic and service clubs
                - Other organizations that provide educational resources to immigrants

Registration is subject to review to ensure eligibility. If eligible, organizations will receive one copy of the Toolkit on a first-come, first-served basis. Resources are limited. See below for information on purchasing additional copies. Registration will be open while supplies last. Organizations may register for one additional free toolkit five or more years after the original request.

**PERSONAL REQUESTS BY INDIVIDUALS WILL NOT BE ACCEPTED**. For personal requests visit the U.S. Government Bookstore.

Required Fields

## Purchasing Information

Additional Toolkits may be purchased from the U.S. Government Bookstore. There are no restrictions to purchase the Toolkit. Interested individuals or organizations that do not qualify to receive a free Toolkit may purchase a copy instead.

## Privacy Act Statement

**AUTHORITY:** The information requested on this form is collected pursuant to § 451(f)(2) of the Homeland Security Act of 2002, Public Law 107-296.

**PURPOSES:** The primary purpose for providing the requested information on this form is to request a copy of the Civics and Citizenship Toolkit. Contact information may also be used to provide information regarding USCIS citizenship-related products, resources, and training opportunities.

**DISCLOSURE:** The information you provide is voluntary; however, failure to provide full contact information may prevent USCIS from sending you a copy of the Civics and Citizenship Toolkit.

**ROUTINE USES:** The information will be used by and disclosed to DHS personnel and contractors or other agents who need the information to fulfill orders and to deliver future updates regarding USCIS citizenship-related products, resources, and training opportunities. This includes using the information as necessary and authorized by the routine uses published in DHS/All-002 Department of Homeland Security Mailing and Other Lists System of Records, available at www.dhs.gov/privacy

## Paperwork Reduction Act

An agency may not conduct or sponsor an information collection, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The public reporting burden for this collection of information is estimated at 10 minutes per response, including the time for reviewing instructions and completing and submitting the form. Send comment regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: U.S. Citizenship and Immigration Services, Regulatory Products Division, Office of the Executive Secretariat, 20 Massachusetts Ave., N.W., Washington, DC 20529-2020. **Do not mail your application to this address.**