APPLICANT / PASSPORT INFORMATION

Do you have a VAT number? *
Refer to your passport and enter all information in the same format.
Gender: *
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APPLICANT / PASSPORT INFORMATION

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OTHER CITIZENSHIP OR NATIONALITY

Are you now, a citizen or national of any other country? * 🛈
Have you ever been a citizen or national of any other country? * 🛈
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Are you known by any other names names or aliases? * 🛈
Have you ever been issued a passport or national identity card for travel by any other country? * 🛈

YOUR CONTACT INFORMATION

Please fill in your home address
 

SOCIAL MEDIA

Please enter information associated with your online presence
over the past five years 🛈

GE MEMBERSHIP

Are you a member of the CBP Global Entry Program? *

PARENTS

EMPLOYMENT INFORMATION

Do you have a current or previous employer? * 🛈

ENTER TRAVEL INFORMATION

Is your travel to the US occurring in transit to another country?
 * 🛈

U.S. POINT OF CONTACT INFORMATION -
if you do not know write UNKNOWN

ADDRESS WHILE IN THE U.S - SAME AS U.S. POINT OF CONTACT INFO ABOVE *

EMERGENCY CONTACT INFORMATION IN OR OUT OF THE U.S.

Who should be contacted in the event of an accident?

ELIGIBILITY QUESTIONS

1) Do you have a physical or mental disorder; or are you a drug abuser or addict;
or do you currently have any of the following diseases (communicable diseases are
specified pursuant to section 361(b) of the Public Health Service Act):

  • Cholera
  • Diphtheria
  • Tuberculosis, infectious
  • Plague
  • Smallpox
  • Yellow Fever
  • Viral Hemorrhagic Fevers, including Ebola, Lassa, Marburg, Crimean-Congo
  • Severe acute respiratory illnesses capable of transmission to other
    persons and likely to cause mortality.
 * 🛈
2) Have you ever been arrested or convicted for a crime that resulted in serious
damage to property, or serious harm to another person or government authority? * 🛈
3) Have you ever violated any law related to possessing, using, or distributing illegal drugs?
 * 🛈
4) Do you seek to engage in or have you ever engaged in terrorist activities, espionage, sabotage, or genocide?
 *
5) Have you ever committed fraud or misrepresented yourself or others to obtain, or assist others to
obtain, a visa or entry into the United States?
 *
6) Are you currently seeking employment in the United States or were you previously employed in the United States without prior permission from the U.S. government?
 *
7) Have you ever been denied a U.S. visa you applied for with your current or previous passport,
or have you ever been refused admission to the United States or withdrawn your application for
admission at a U.S. port of entry?
 *
8) Have you ever stayed in the United States longer than the admission period
granted to you by the U.S. government?
 *
9) Have you traveled to, or been present in Iran, Iraq, Libya, North Korea, Somalia, Sudan, Syria
or Yemen on or after March 1, 2011?
 *

YOUR APPLICATION CAN'T PROCEED AS YOU ANSWERED YES TO THIS QUESTION.
PLEASE CONTACT YOUR NEAREST U.S. EMBASSY FOR FURTHER INFORMATION