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All questions must be answered in English using English-language characters only,
except
when you are asked to provide your full name in your native alphabet.
Applicant's Basic Information
Family Name
*
First (Given) Name
*
Do you have any other names or name aliases?
*
No
Yes
Gender
*
Male
Female
Date of Birth
*
Year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
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2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
1909
1908
1907
1906
1905
1904
1903
1902
1901
1900
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
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4
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13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Country of Birth
*
Select country
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua And Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius And Saba
Bosnia And Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burma
Burundi
Cambodia
Cameroon
Canada
Canton And Enderbury Islands
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (keeling) Islands
Colombia
Comoros
Congo, Democratic Republic Of
Congo, Republic Of
Cook Islands
Costa Rica
Cote D'ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Yemen
Denmark
Djibouti
Dominica
Dominican Republic
Dronning Maud Land
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
France Metropolitan
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-bissau
Guyana
Haiti
Heard And Mc Donald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle Of Man
Israel
Italy
Jamaica
Japan
Jersey
Johnston Island
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia - Federated States Of
Midway Islands
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
Neutral Zone
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territories
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Barthelemy
Saint Kitts And Nevis
Saint Lucia
Saint Martin (french Part)
Saint Vincent And The Grenadines
Samoa
San Marino
Sao Tome And Principe
Saudi Arabia
Senegal
Serbia
Serbia And Montenegro
Seychelles
Sierra Leone
Singapore
Sint Maarten (dutch Part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia And The South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
St. Helena
St. Pierre And Miquelon
Sudan
Suriname
Svalbard And Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-leste
Togo
Tokelau
Tonga
Trinidad And Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City State (holy See)
Venezuela
Vietnam
Virgin Islands (british)
Virgin Islands (u.s.)
Wake Island
Wallis And Futuna Islands
Western Sahara
Yemen
Zaire
Zambia
Zimbabwe
City of Birth
(Optional)
If you can't find this listed on your passport, you may enter the name of the city/town/village where you were born.
Are you a member of the CBP Global Entry Program?
*
No
Yes
Global Entry Number / PassID
*
Passport Information
Passport Number
*
Country of Citizenship
*
Select country
Andorra
Australia
Austria
Belgium
Brunei
Chile
Croatia
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Japan
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Monaco
Netherlands
New Zealand
Norway
Poland
Portugal
San Marino
Singapore
Slovakia
Slovenia
South Korea
Spain
Sweden
Switzerland
Taiwan
Uk - British Citizen
National
Personal
Identification Number
*
Enter the number on your identity document, other than a passport issued by your country. The
National
Personal
Identification Number, if issued to you, is required to complete the application.
If you do not have a National Identification Number, enter UNKNOWN.
Passport Issuance Date
*
Year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Passport Expiration Date
*
Year
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Issuance Country
*
Select country
Andorra
Australia
Austria
Belgium
Brunei
Chile
Croatia
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Japan
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Monaco
Netherlands
New Zealand
Norway
Poland
Portugal
San Marino
Singapore
Slovakia
Slovenia
South Korea
Spain
Sweden
Switzerland
Taiwan
Uk - British Citizen
Issuance Country must match Country of Citizenship
Upload Passport Picture
*
Choose file
Upload a picture of your passport page that shows your photo, information about you, and the machine readable section as shown in the image below.
Other Citizenship and Travel Documents
Are you now, a citizen or national of any other country?
*
No
Yes
Have you ever been a citizen or national of any other country in the past?
*
No
Yes
Have you ever been issued a passport or national identity card for travel by any other country?
*
No
Yes
Applicant's Address
Country
*
Select country
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua And Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius And Saba
Bosnia And Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burma
Burundi
Cambodia
Cameroon
Canada
Canton And Enderbury Islands
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (keeling) Islands
Colombia
Comoros
Congo, Democratic Republic Of
Congo, Republic Of
Cook Islands
Costa Rica
Cote D'ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Yemen
Denmark
Djibouti
Dominica
Dominican Republic
Dronning Maud Land
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
France Metropolitan
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-bissau
Guyana
Haiti
Heard And Mc Donald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle Of Man
Israel
Italy
Jamaica
Japan
Jersey
Johnston Island
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia - Federated States Of
Midway Islands
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
Neutral Zone
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territories
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Barthelemy
Saint Kitts And Nevis
Saint Lucia
Saint Martin (french Part)
Saint Vincent And The Grenadines
Samoa
San Marino
Sao Tome And Principe
Saudi Arabia
Senegal
Serbia
Serbia And Montenegro
Seychelles
Sierra Leone
Singapore
Sint Maarten (dutch Part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia And The South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
St. Helena
St. Pierre And Miquelon
Sudan
Suriname
Svalbard And Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-leste
Togo
Tokelau
Tonga
Trinidad And Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City State (holy See)
Venezuela
Vietnam
Virgin Islands (british)
Virgin Islands (u.s.)
Wake Island
Wallis And Futuna Islands
Western Sahara
Yemen
Zaire
Zambia
Zimbabwe
Address Line 1
*
Address Line 2
(Optional)
Apartment Number
(Optional)
City
*
State/Province/Region
*
Select state
State/Province/Region
*
Zip Code/Postal Code
(Optional)
Parents Information
If you do not enter one or both parents, UNKNOWN will be used in the application.
Father's First Name
(Optional)
Father's Last Name
(Optional)
Mother's First Name
(Optional)
Mother's Last Name
(Optional)
Employment Information
Do you have a current or previous employer?
*
No
Yes
Job Title
(Optional)
Employer
*
Country
*
Select country
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua And Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius And Saba
Bosnia And Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burma
Burundi
Cambodia
Cameroon
Canada
Canton And Enderbury Islands
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (keeling) Islands
Colombia
Comoros
Congo, Democratic Republic Of
Congo, Republic Of
Cook Islands
Costa Rica
Cote D'ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Yemen
Denmark
Djibouti
Dominica
Dominican Republic
Dronning Maud Land
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
France Metropolitan
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-bissau
Guyana
Haiti
Heard And Mc Donald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle Of Man
Israel
Italy
Jamaica
Japan
Jersey
Johnston Island
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia - Federated States Of
Midway Islands
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
Neutral Zone
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territories
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Barthelemy
Saint Kitts And Nevis
Saint Lucia
Saint Martin (french Part)
Saint Vincent And The Grenadines
Samoa
San Marino
Sao Tome And Principe
Saudi Arabia
Senegal
Serbia
Serbia And Montenegro
Seychelles
Sierra Leone
Singapore
Sint Maarten (dutch Part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia And The South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
St. Helena
St. Pierre And Miquelon
Sudan
Suriname
Svalbard And Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-leste
Togo
Tokelau
Tonga
Trinidad And Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City State (holy See)
Venezuela
Vietnam
Virgin Islands (british)
Virgin Islands (u.s.)
Wake Island
Wallis And Futuna Islands
Western Sahara
Yemen
Zaire
Zambia
Zimbabwe
Address Line 1
*
Address Line 2
(Optional)
City
*
State/Province/Region
*
Select state
State/Province/Region
*
Phone Number
(Optional)
Phone Code
(Optional)
Select country code
AFGHANISTAN (+93)
ALAND ISLANDS (+358)
ALBANIA (+355)
ALGERIA (+213)
AMERICAN SAMOA (+1)
ANDORRA (+376)
ANGOLA (+244)
ANGUILLA (+1)
ANTARCTICA (+672)
ANTIGUA AND BARBUDA (+1)
ARGENTINA (+54)
ARMENIA (+374)
ARUBA (+297)
AUSTRALIA (+61)
AUSTRIA (+43)
AZERBAIJAN (+994)
BAHAMAS (+1)
BAHRAIN (+973)
BANGLADESH (+880)
BARBADOS (+1)
BELARUS (+375)
BELGIUM (+32)
BELIZE (+501)
BENIN (+229)
BERMUDA (+1)
BHUTAN (+975)
BOLIVIA (+591)
BONAIRE, SINT EUSTATIUS AND SABA (+599)
BOSNIA AND HERZEGOVINA (+387)
BOTSWANA (+267)
BOUVET ISLAND (+55)
BRAZIL (+55)
BRITISH INDIAN OCEAN TERRITORY (+246)
BRUNEI (+673)
BULGARIA (+359)
BURKINA FASO (+226)
BURMA (+95)
BURUNDI (+257)
CAMBODIA (+855)
CAMEROON (+237)
CANADA (+1)
CANTON AND ENDERBURY ISLANDS (+686)
CAPE VERDE (+238)
CAYMAN ISLANDS (+1)
CENTRAL AFRICAN REPUBLIC (+236)
CHAD (+235)
CHILE (+56)
CHINA (+86)
CHRISTMAS ISLAND (+61)
COCOS (KEELING) ISLANDS (+61)
COLOMBIA (+57)
COMOROS (+269)
CONGO, DEMOCRATIC REPUBLIC OF (+243)
CONGO, REPUBLIC OF (+242)
COOK ISLANDS (+682)
COSTA RICA (+506)
COTE D'IVOIRE (+225)
CROATIA (+385)
CUBA (+53)
CURACAO (+599)
CYPRUS (+357)
CZECH REPUBLIC (+420)
DEMOCRATIC YEMEN (+967)
DENMARK (+45)
DJIBOUTI (+253)
DOMINICA (+1)
DOMINICAN REPUBLIC (+1)
EAST TIMOR (+670)
ECUADOR (+593)
EGYPT (+20)
EL SALVADOR (+503)
EQUATORIAL GUINEA (+240)
ERITREA (+291)
ESTONIA (+372)
ETHIOPIA (+251)
FALKLAND ISLANDS (+500)
FAROE ISLANDS (+298)
FIJI (+679)
FINLAND (+358)
FRANCE (+33)
FRANCE METROPOLITAN (+33)
FRENCH GUIANA (+594)
FRENCH POLYNESIA (+689)
FRENCH SOUTHERN TERRITORIES (+262)
GABON (+241)
GAMBIA (+220)
GEORGIA (+995)
GERMANY (+49)
GHANA (+233)
GIBRALTAR (+350)
GREECE (+30)
GREENLAND (+299)
GRENADA (+1)
GUADELOUPE (+590)
GUAM (+1)
GUATEMALA (+502)
GUERNSEY (+44)
GUINEA (+224)
GUINEA-BISSAU (+245)
GUYANA (+592)
HAITI (+509)
HEARD AND MC DONALD ISLANDS (+0)
HONDURAS (+504)
HONG KONG (+852)
HUNGARY (+36)
ICELAND (+354)
INDIA (+91)
INDONESIA (+62)
IRAN (+98)
IRAQ (+964)
IRELAND (+353)
ISLE OF MAN (+44)
ISRAEL (+972)
ITALY (+39)
JAMAICA (+1)
JAPAN (+81)
JERSEY (+44)
JOHNSTON ISLAND (+1)
JORDAN (+962)
KAZAKHSTAN (+7)
KENYA (+254)
KIRIBATI (+686)
KOSOVO (+383)
KUWAIT (+965)
KYRGYZSTAN (+996)
LAOS (+856)
LATVIA (+371)
LEBANON (+961)
LESOTHO (+266)
LIBERIA (+231)
LIBYA (+218)
LIECHTENSTEIN (+423)
LITHUANIA (+370)
LUXEMBOURG (+352)
MACAU (+853)
MACEDONIA (+389)
MADAGASCAR (+261)
MALAWI (+265)
MALAYSIA (+60)
MALDIVES (+960)
MALI (+223)
MALTA (+356)
MARSHALL ISLANDS (+692)
MARTINIQUE (+596)
MAURITANIA (+222)
MAURITIUS (+230)
MAYOTTE (+262)
MEXICO (+52)
MICRONESIA - FEDERATED STATES OF (+691)
MIDWAY ISLANDS (+1)
MOLDOVA (+373)
MONACO (+377)
MONGOLIA (+976)
MONTENEGRO (+382)
MONTSERRAT (+1)
MOROCCO (+212)
MOZAMBIQUE (+258)
MYANMAR (+95)
NAMIBIA (+264)
NAURU (+674)
NEPAL (+977)
NETHERLANDS (+31)
NETHERLANDS ANTILLES (+599)
NEW CALEDONIA (+687)
NEW ZEALAND (+64)
NICARAGUA (+505)
NIGER (+227)
NIGERIA (+234)
NIUE (+683)
NORFOLK ISLAND (+672)
NORTH KOREA (+850)
NORTHERN MARIANA ISLANDS (+1)
NORWAY (+47)
OMAN (+968)
PAKISTAN (+92)
PALAU (+680)
PALESTINIAN TERRITORIES (+970)
PANAMA (+507)
PANAMA CANAL ZONE (+507)
PAPUA NEW GUINEA (+675)
PARAGUAY (+595)
PERU (+51)
PHILIPPINES (+63)
PITCAIRN (+64)
POLAND (+48)
PORTUGAL (+351)
PUERTO RICO (+1)
QATAR (+974)
REUNION (+262)
ROMANIA (+40)
RUSSIAN FEDERATION (+7)
RWANDA (+250)
SAMOA (+685)
SAN MARINO (+378)
SAO TOME AND PRINCIPE (+239)
SAUDI ARABIA (+966)
SENEGAL (+221)
SERBIA (+381)
SERBIA AND MONTENEGRO (+381)
SEYCHELLES (+248)
SIERRA LEONE (+232)
SINGAPORE (+65)
SINT MAARTEN (DUTCH PART) (+1)
SLOVAKIA (+421)
SLOVENIA (+386)
SOLOMON ISLANDS (+677)
SOMALIA (+252)
SOUTH AFRICA (+27)
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS (+500)
SOUTH KOREA (+82)
SOUTH SUDAN (+211)
SPAIN (+34)
SRI LANKA (+94)
ST. BARTHÉLEMY (+590)
ST. HELENA (+290)
ST. KITTS AND NEVIS (+1)
ST. LUCIA (+1)
ST. MARTIN (+590)
ST. PIERRE AND MIQUELON (+508)
ST. VINCENT AND THE GRENADINES (+1)
SUDAN (+249)
SURINAME (+597)
SVALBARD AND JAN MAYEN ISLANDS (+47)
SWAZILAND (+268)
SWEDEN (+46)
SWITZERLAND (+41)
SYRIA (+963)
TAIWAN (+886)
TAJIKISTAN (+992)
TANZANIA (+255)
THAILAND (+66)
TIMOR-LESTE (+670)
TOGO (+228)
TOKELAU (+690)
TONGA (+676)
TRINIDAD AND TOBAGO (+1)
TUNISIA (+216)
TURKEY (+90)
TURKMENISTAN (+993)
TURKS AND CAICOS ISLANDS (+1)
TUVALU (+688)
U.S. MINOR OUTLYING ISLANDS (+1)
U.S. MISCELLANEOUS PACIFIC ISLANDS (+1)
UGANDA (+256)
UKRAINE (+380)
UNION OF SOVIET SOCIALIST REPUBLICS (+7)
UNITED ARAB EMIRATES (+971)
UNITED KINGDOM (+44)
UNITED STATES (+1)
UNKNOWN OR UNSPECIFIED COUNTRY (+0)
URUGUAY (+598)
UZBEKISTAN (+998)
VANUATU (+678)
VATICAN CITY STATE (HOLY SEE) (+39)
VENEZUELA (+58)
VIETNAM (+84)
VIRGIN ISLANDS (BRITISH) (+1)
VIRGIN ISLANDS (U.S.) (+1)
WALLIS AND FUTUNA ISLANDS (+681)
WESTERN SAHARA (+212)
YEMEN (+967)
ZAIRE (+243)
ZAMBIA (+260)
ZIMBABWE (+263)
Travel Information
Is your travel to the US occurring in transit to another country?
*
No
Yes
Do you have a US point of contact that you would like to add?
(Optional)
No
Yes
US Point of Contact Information
Full Name of Hotel / Business / Friends or Relatives to be visited in U.S.
(Optional)
Address Line 1
(Optional)
Address Line 2
(Optional)
Apartment Number
(Optional)
City
(Optional)
State
(Optional)
Select state
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Unknown
Phone Number of Hotel / Business / Friends or Relatives in the U.S.
(Optional)
Phone Code
(Optional)
Select country code
AFGHANISTAN (+93)
ALAND ISLANDS (+358)
ALBANIA (+355)
ALGERIA (+213)
AMERICAN SAMOA (+1)
ANDORRA (+376)
ANGOLA (+244)
ANGUILLA (+1)
ANTARCTICA (+672)
ANTIGUA AND BARBUDA (+1)
ARGENTINA (+54)
ARMENIA (+374)
ARUBA (+297)
AUSTRALIA (+61)
AUSTRIA (+43)
AZERBAIJAN (+994)
BAHAMAS (+1)
BAHRAIN (+973)
BANGLADESH (+880)
BARBADOS (+1)
BELARUS (+375)
BELGIUM (+32)
BELIZE (+501)
BENIN (+229)
BERMUDA (+1)
BHUTAN (+975)
BOLIVIA (+591)
BONAIRE, SINT EUSTATIUS AND SABA (+599)
BOSNIA AND HERZEGOVINA (+387)
BOTSWANA (+267)
BOUVET ISLAND (+55)
BRAZIL (+55)
BRITISH INDIAN OCEAN TERRITORY (+246)
BRUNEI (+673)
BULGARIA (+359)
BURKINA FASO (+226)
BURMA (+95)
BURUNDI (+257)
CAMBODIA (+855)
CAMEROON (+237)
CANADA (+1)
CANTON AND ENDERBURY ISLANDS (+686)
CAPE VERDE (+238)
CAYMAN ISLANDS (+1)
CENTRAL AFRICAN REPUBLIC (+236)
CHAD (+235)
CHILE (+56)
CHINA (+86)
CHRISTMAS ISLAND (+61)
COCOS (KEELING) ISLANDS (+61)
COLOMBIA (+57)
COMOROS (+269)
CONGO, DEMOCRATIC REPUBLIC OF (+243)
CONGO, REPUBLIC OF (+242)
COOK ISLANDS (+682)
COSTA RICA (+506)
COTE D'IVOIRE (+225)
CROATIA (+385)
CUBA (+53)
CURACAO (+599)
CYPRUS (+357)
CZECH REPUBLIC (+420)
DEMOCRATIC YEMEN (+967)
DENMARK (+45)
DJIBOUTI (+253)
DOMINICA (+1)
DOMINICAN REPUBLIC (+1)
EAST TIMOR (+670)
ECUADOR (+593)
EGYPT (+20)
EL SALVADOR (+503)
EQUATORIAL GUINEA (+240)
ERITREA (+291)
ESTONIA (+372)
ETHIOPIA (+251)
FALKLAND ISLANDS (+500)
FAROE ISLANDS (+298)
FIJI (+679)
FINLAND (+358)
FRANCE (+33)
FRANCE METROPOLITAN (+33)
FRENCH GUIANA (+594)
FRENCH POLYNESIA (+689)
FRENCH SOUTHERN TERRITORIES (+262)
GABON (+241)
GAMBIA (+220)
GEORGIA (+995)
GERMANY (+49)
GHANA (+233)
GIBRALTAR (+350)
GREECE (+30)
GREENLAND (+299)
GRENADA (+1)
GUADELOUPE (+590)
GUAM (+1)
GUATEMALA (+502)
GUERNSEY (+44)
GUINEA (+224)
GUINEA-BISSAU (+245)
GUYANA (+592)
HAITI (+509)
HEARD AND MC DONALD ISLANDS (+0)
HONDURAS (+504)
HONG KONG (+852)
HUNGARY (+36)
ICELAND (+354)
INDIA (+91)
INDONESIA (+62)
IRAN (+98)
IRAQ (+964)
IRELAND (+353)
ISLE OF MAN (+44)
ISRAEL (+972)
ITALY (+39)
JAMAICA (+1)
JAPAN (+81)
JERSEY (+44)
JOHNSTON ISLAND (+1)
JORDAN (+962)
KAZAKHSTAN (+7)
KENYA (+254)
KIRIBATI (+686)
KOSOVO (+383)
KUWAIT (+965)
KYRGYZSTAN (+996)
LAOS (+856)
LATVIA (+371)
LEBANON (+961)
LESOTHO (+266)
LIBERIA (+231)
LIBYA (+218)
LIECHTENSTEIN (+423)
LITHUANIA (+370)
LUXEMBOURG (+352)
MACAU (+853)
MACEDONIA (+389)
MADAGASCAR (+261)
MALAWI (+265)
MALAYSIA (+60)
MALDIVES (+960)
MALI (+223)
MALTA (+356)
MARSHALL ISLANDS (+692)
MARTINIQUE (+596)
MAURITANIA (+222)
MAURITIUS (+230)
MAYOTTE (+262)
MEXICO (+52)
MICRONESIA - FEDERATED STATES OF (+691)
MIDWAY ISLANDS (+1)
MOLDOVA (+373)
MONACO (+377)
MONGOLIA (+976)
MONTENEGRO (+382)
MONTSERRAT (+1)
MOROCCO (+212)
MOZAMBIQUE (+258)
MYANMAR (+95)
NAMIBIA (+264)
NAURU (+674)
NEPAL (+977)
NETHERLANDS (+31)
NETHERLANDS ANTILLES (+599)
NEW CALEDONIA (+687)
NEW ZEALAND (+64)
NICARAGUA (+505)
NIGER (+227)
NIGERIA (+234)
NIUE (+683)
NORFOLK ISLAND (+672)
NORTH KOREA (+850)
NORTHERN MARIANA ISLANDS (+1)
NORWAY (+47)
OMAN (+968)
PAKISTAN (+92)
PALAU (+680)
PALESTINIAN TERRITORIES (+970)
PANAMA (+507)
PANAMA CANAL ZONE (+507)
PAPUA NEW GUINEA (+675)
PARAGUAY (+595)
PERU (+51)
PHILIPPINES (+63)
PITCAIRN (+64)
POLAND (+48)
PORTUGAL (+351)
PUERTO RICO (+1)
QATAR (+974)
REUNION (+262)
ROMANIA (+40)
RUSSIAN FEDERATION (+7)
RWANDA (+250)
SAMOA (+685)
SAN MARINO (+378)
SAO TOME AND PRINCIPE (+239)
SAUDI ARABIA (+966)
SENEGAL (+221)
SERBIA (+381)
SERBIA AND MONTENEGRO (+381)
SEYCHELLES (+248)
SIERRA LEONE (+232)
SINGAPORE (+65)
SINT MAARTEN (DUTCH PART) (+1)
SLOVAKIA (+421)
SLOVENIA (+386)
SOLOMON ISLANDS (+677)
SOMALIA (+252)
SOUTH AFRICA (+27)
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS (+500)
SOUTH KOREA (+82)
SOUTH SUDAN (+211)
SPAIN (+34)
SRI LANKA (+94)
ST. BARTHÉLEMY (+590)
ST. HELENA (+290)
ST. KITTS AND NEVIS (+1)
ST. LUCIA (+1)
ST. MARTIN (+590)
ST. PIERRE AND MIQUELON (+508)
ST. VINCENT AND THE GRENADINES (+1)
SUDAN (+249)
SURINAME (+597)
SVALBARD AND JAN MAYEN ISLANDS (+47)
SWAZILAND (+268)
SWEDEN (+46)
SWITZERLAND (+41)
SYRIA (+963)
TAIWAN (+886)
TAJIKISTAN (+992)
TANZANIA (+255)
THAILAND (+66)
TIMOR-LESTE (+670)
TOGO (+228)
TOKELAU (+690)
TONGA (+676)
TRINIDAD AND TOBAGO (+1)
TUNISIA (+216)
TURKEY (+90)
TURKMENISTAN (+993)
TURKS AND CAICOS ISLANDS (+1)
TUVALU (+688)
U.S. MINOR OUTLYING ISLANDS (+1)
U.S. MISCELLANEOUS PACIFIC ISLANDS (+1)
UGANDA (+256)
UKRAINE (+380)
UNION OF SOVIET SOCIALIST REPUBLICS (+7)
UNITED ARAB EMIRATES (+971)
UNITED KINGDOM (+44)
UNITED STATES (+1)
UNKNOWN OR UNSPECIFIED COUNTRY (+0)
URUGUAY (+598)
UZBEKISTAN (+998)
VANUATU (+678)
VATICAN CITY STATE (HOLY SEE) (+39)
VENEZUELA (+58)
VIETNAM (+84)
VIRGIN ISLANDS (BRITISH) (+1)
VIRGIN ISLANDS (U.S.) (+1)
WALLIS AND FUTUNA ISLANDS (+681)
WESTERN SAHARA (+212)
YEMEN (+967)
ZAIRE (+243)
ZAMBIA (+260)
ZIMBABWE (+263)
Is your address while in the U.S. same as the U.S. Contact address listed above?
*
No
Yes
Address While in the US
The address where you will be staying in the U.S. is optional to complete the application. If multiple locations are planned, enter the first address. If the complete address is not known, enter the name of the hotel or location you will visit.
Address Line 1
(Optional)
Address Line 2
(Optional)
Apartment Number
(Optional)
City
(Optional)
State
(Optional)
Select state
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Unknown
Do you have an emergency contact that you would like to add?
(Optional)
No
Yes
Emergency Contact Information In or Out of US
Family Name
(Optional)
First (Given) Name
(Optional)
Email
(Optional)
Phone Number
(Optional)
Phone Code
(Optional)
Select country code
AFGHANISTAN (+93)
ALAND ISLANDS (+358)
ALBANIA (+355)
ALGERIA (+213)
AMERICAN SAMOA (+1)
ANDORRA (+376)
ANGOLA (+244)
ANGUILLA (+1)
ANTARCTICA (+672)
ANTIGUA AND BARBUDA (+1)
ARGENTINA (+54)
ARMENIA (+374)
ARUBA (+297)
AUSTRALIA (+61)
AUSTRIA (+43)
AZERBAIJAN (+994)
BAHAMAS (+1)
BAHRAIN (+973)
BANGLADESH (+880)
BARBADOS (+1)
BELARUS (+375)
BELGIUM (+32)
BELIZE (+501)
BENIN (+229)
BERMUDA (+1)
BHUTAN (+975)
BOLIVIA (+591)
BONAIRE, SINT EUSTATIUS AND SABA (+599)
BOSNIA AND HERZEGOVINA (+387)
BOTSWANA (+267)
BOUVET ISLAND (+55)
BRAZIL (+55)
BRITISH INDIAN OCEAN TERRITORY (+246)
BRUNEI (+673)
BULGARIA (+359)
BURKINA FASO (+226)
BURMA (+95)
BURUNDI (+257)
CAMBODIA (+855)
CAMEROON (+237)
CANADA (+1)
CANTON AND ENDERBURY ISLANDS (+686)
CAPE VERDE (+238)
CAYMAN ISLANDS (+1)
CENTRAL AFRICAN REPUBLIC (+236)
CHAD (+235)
CHILE (+56)
CHINA (+86)
CHRISTMAS ISLAND (+61)
COCOS (KEELING) ISLANDS (+61)
COLOMBIA (+57)
COMOROS (+269)
CONGO, DEMOCRATIC REPUBLIC OF (+243)
CONGO, REPUBLIC OF (+242)
COOK ISLANDS (+682)
COSTA RICA (+506)
COTE D'IVOIRE (+225)
CROATIA (+385)
CUBA (+53)
CURACAO (+599)
CYPRUS (+357)
CZECH REPUBLIC (+420)
DEMOCRATIC YEMEN (+967)
DENMARK (+45)
DJIBOUTI (+253)
DOMINICA (+1)
DOMINICAN REPUBLIC (+1)
EAST TIMOR (+670)
ECUADOR (+593)
EGYPT (+20)
EL SALVADOR (+503)
EQUATORIAL GUINEA (+240)
ERITREA (+291)
ESTONIA (+372)
ETHIOPIA (+251)
FALKLAND ISLANDS (+500)
FAROE ISLANDS (+298)
FIJI (+679)
FINLAND (+358)
FRANCE (+33)
FRANCE METROPOLITAN (+33)
FRENCH GUIANA (+594)
FRENCH POLYNESIA (+689)
FRENCH SOUTHERN TERRITORIES (+262)
GABON (+241)
GAMBIA (+220)
GEORGIA (+995)
GERMANY (+49)
GHANA (+233)
GIBRALTAR (+350)
GREECE (+30)
GREENLAND (+299)
GRENADA (+1)
GUADELOUPE (+590)
GUAM (+1)
GUATEMALA (+502)
GUERNSEY (+44)
GUINEA (+224)
GUINEA-BISSAU (+245)
GUYANA (+592)
HAITI (+509)
HEARD AND MC DONALD ISLANDS (+0)
HONDURAS (+504)
HONG KONG (+852)
HUNGARY (+36)
ICELAND (+354)
INDIA (+91)
INDONESIA (+62)
IRAN (+98)
IRAQ (+964)
IRELAND (+353)
ISLE OF MAN (+44)
ISRAEL (+972)
ITALY (+39)
JAMAICA (+1)
JAPAN (+81)
JERSEY (+44)
JOHNSTON ISLAND (+1)
JORDAN (+962)
KAZAKHSTAN (+7)
KENYA (+254)
KIRIBATI (+686)
KOSOVO (+383)
KUWAIT (+965)
KYRGYZSTAN (+996)
LAOS (+856)
LATVIA (+371)
LEBANON (+961)
LESOTHO (+266)
LIBERIA (+231)
LIBYA (+218)
LIECHTENSTEIN (+423)
LITHUANIA (+370)
LUXEMBOURG (+352)
MACAU (+853)
MACEDONIA (+389)
MADAGASCAR (+261)
MALAWI (+265)
MALAYSIA (+60)
MALDIVES (+960)
MALI (+223)
MALTA (+356)
MARSHALL ISLANDS (+692)
MARTINIQUE (+596)
MAURITANIA (+222)
MAURITIUS (+230)
MAYOTTE (+262)
MEXICO (+52)
MICRONESIA - FEDERATED STATES OF (+691)
MIDWAY ISLANDS (+1)
MOLDOVA (+373)
MONACO (+377)
MONGOLIA (+976)
MONTENEGRO (+382)
MONTSERRAT (+1)
MOROCCO (+212)
MOZAMBIQUE (+258)
MYANMAR (+95)
NAMIBIA (+264)
NAURU (+674)
NEPAL (+977)
NETHERLANDS (+31)
NETHERLANDS ANTILLES (+599)
NEW CALEDONIA (+687)
NEW ZEALAND (+64)
NICARAGUA (+505)
NIGER (+227)
NIGERIA (+234)
NIUE (+683)
NORFOLK ISLAND (+672)
NORTH KOREA (+850)
NORTHERN MARIANA ISLANDS (+1)
NORWAY (+47)
OMAN (+968)
PAKISTAN (+92)
PALAU (+680)
PALESTINIAN TERRITORIES (+970)
PANAMA (+507)
PANAMA CANAL ZONE (+507)
PAPUA NEW GUINEA (+675)
PARAGUAY (+595)
PERU (+51)
PHILIPPINES (+63)
PITCAIRN (+64)
POLAND (+48)
PORTUGAL (+351)
PUERTO RICO (+1)
QATAR (+974)
REUNION (+262)
ROMANIA (+40)
RUSSIAN FEDERATION (+7)
RWANDA (+250)
SAMOA (+685)
SAN MARINO (+378)
SAO TOME AND PRINCIPE (+239)
SAUDI ARABIA (+966)
SENEGAL (+221)
SERBIA (+381)
SERBIA AND MONTENEGRO (+381)
SEYCHELLES (+248)
SIERRA LEONE (+232)
SINGAPORE (+65)
SINT MAARTEN (DUTCH PART) (+1)
SLOVAKIA (+421)
SLOVENIA (+386)
SOLOMON ISLANDS (+677)
SOMALIA (+252)
SOUTH AFRICA (+27)
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS (+500)
SOUTH KOREA (+82)
SOUTH SUDAN (+211)
SPAIN (+34)
SRI LANKA (+94)
ST. BARTHÉLEMY (+590)
ST. HELENA (+290)
ST. KITTS AND NEVIS (+1)
ST. LUCIA (+1)
ST. MARTIN (+590)
ST. PIERRE AND MIQUELON (+508)
ST. VINCENT AND THE GRENADINES (+1)
SUDAN (+249)
SURINAME (+597)
SVALBARD AND JAN MAYEN ISLANDS (+47)
SWAZILAND (+268)
SWEDEN (+46)
SWITZERLAND (+41)
SYRIA (+963)
TAIWAN (+886)
TAJIKISTAN (+992)
TANZANIA (+255)
THAILAND (+66)
TIMOR-LESTE (+670)
TOGO (+228)
TOKELAU (+690)
TONGA (+676)
TRINIDAD AND TOBAGO (+1)
TUNISIA (+216)
TURKEY (+90)
TURKMENISTAN (+993)
TURKS AND CAICOS ISLANDS (+1)
TUVALU (+688)
U.S. MINOR OUTLYING ISLANDS (+1)
U.S. MISCELLANEOUS PACIFIC ISLANDS (+1)
UGANDA (+256)
UKRAINE (+380)
UNION OF SOVIET SOCIALIST REPUBLICS (+7)
UNITED ARAB EMIRATES (+971)
UNITED KINGDOM (+44)
UNITED STATES (+1)
UNKNOWN OR UNSPECIFIED COUNTRY (+0)
URUGUAY (+598)
UZBEKISTAN (+998)
VANUATU (+678)
VATICAN CITY STATE (HOLY SEE) (+39)
VENEZUELA (+58)
VIETNAM (+84)
VIRGIN ISLANDS (BRITISH) (+1)
VIRGIN ISLANDS (U.S.) (+1)
WALLIS AND FUTUNA ISLANDS (+681)
WESTERN SAHARA (+212)
YEMEN (+967)
ZAIRE (+243)
ZAMBIA (+260)
ZIMBABWE (+263)
Eligibility Information
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
No
Yes
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?
*
No
Yes
Have you ever violated any law related to possessing, using, or distributing illegal drugs?
*
No
Yes
Do you seek to engage in or have you ever engaged in terrorist activities, espionage, sabotage, or genocide?
*
No
Yes
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?
*
No
Yes
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?
*
No
Yes
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?
*
No
Yes
When
Where
Have you ever stayed in the United States longer than the admission period granted to you by the U.S. government?
*
No
Yes
Have you traveled to or been present in Cuba, Iran, Iraq, Libya, North Korea, Somalia, Sudan, Syria, or Yemen on or after March 1, 2011?
*
No
Yes
Contact Information
Email
*
Re-enter Email
*
Agreement
Required: Please accept agreement.
By checking this box, I am electronically signing to authorize ESTA Assist to use the information I provided on this form to apply for ESTA for me. I have read and understood the terms of the Visa Waiver Program. I understand that if my Electronic Travel Authorization is approved, this approval establishes that I am eligible to travel to the United States under the Visa Waiver Program but does not guarantee that I am admissible to the United States. Upon arrival in the United States, I will be inspected by a Customs and Border Protection officer at a port of entry who may determine that I am inadmissible under the Visa Waiver Program or for any reason under United States law. I understand that attempting to obtain an Electronic System for Travel Authorization(ESTA) under the US Visa Waiver Program by the willful misrepresentation of a material fact, or fraud, is an offense." I agree to receive sms, email and calls about my order and to the privacy policy and terms and conditions listed on this website. I also affirm the information listed above is accurate and truthful. I understand that the US Customs and Border Protection (CBP) provides forms and instructions for filings related to ESTA on their website for a fee. However, I request to use the ESTA Assist service to prepare and submit my application based on the information I have provided. I understand and agree that I will be charged for this service in addition to the fee charged by CBP. ESTA Assist is a third party company and is not associated with any government agency.
*
Submit Application