Report ICE - Faith in the Valley

Valley Watch Network – Community Detainee Reporting Form

Please complete this form to report/refer anyone who has been detained by ICE. Once you submit the form, someone from the Valley Watch Network will follow up with the person and/or family member.

*Disclaimer: By completing and submitting this form, you agree to have someone from the Valley Watch Network contact the detainee and/or family members to screen for possible assistance.

Today's Date*
MM slash DD slash YYYY
Date of Arrest*
MM slash DD slash YYYY
City of Arrest*
Place of Arrest (home, car, work, school, court, raid)*
Name of Detained Person*
First Last
Date of Birth*
MM slash DD slash YYYY
Primary Language*
City of Residence*
Alien Number (A#)*
Name of Primary Contact*
Contact Phone Number*
Address*
Street Address Address Line 2 City State ZIP Code
Is Person Detained a Minor?*
- Yes
- No
- Other
Has the Person Been Detained Before?*
- Yes
- No
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.