Electronic ESTA
E
lectronic
S
ystem for
T
ravel
A
uthorization
What is ESTA
Request
FAQs
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CONTACT
Application
Verification
File Number
Payment
Applicant Information
Family Name
*
Enter your family name as the family name appears on your passport under the Family Name or Surname field. The family name is required to complete the application.
First (Given) Name
*
Enter your first (given) name as the first name appears on your passport under the First or Given Name field. Do not include the middle name in this field. First name is required to complete the application. If you have no first name, then enter the letters FNU which stands for First Name Unknown.
Are you known by any other names or aliases?
*
Indicate whether you are known by any other names or aliases by selecting yes or no. Answering this question is required to complete your application.
Yes
No
Other Names/Aliases
*
Enter up to 10 other names or aliases by which you are known if you selected "yes" to the previous question. At least one entry is required to complete the application. For each alias: In the Family Name field, enter your alternate family name. The family name is required to complete the application. In the First (Given) Name field, enter your alternate first (given) name. Do not include the middle name in this field. The first name is required to complete the application. If you have no alternate first name, then enter the letters FNU which stands for First Name Unknown.
Country of Citizenship
*
Choose the country of citizenship, as it appears on your passport. The passport issuing country is required to complete the application.
AFGHANISTAN (AFG)
ALBANIA (ALB)
ALGERIA (DZA)
AMERICAN SAMOA (ASM)
ANDORRA (AND)
ANGOLA (AGO)
ANGUILLA (AIA)
ANTARCTICA (ATA)
ANTIGUA AND BARBUDA (ATG)
ARGENTINA (ARG)
ARMENIA (ARM)
ARUBA (ABW)
AUSTRALIA (AUS)
AUSTRIA (AUT)
AZERBAIJAN (AZE)
BAHAMAS (BHS)
BAHRAIN (BHR)
BANGLADESH (BGD)
BARBADOS (BRB)
BELARUS (BLR)
BELGIUM (BEL)
BELIZE (BLZ)
BENIN (BEN)
BERMUDA (BMU)
BHUTAN (BTN)
BOLIVIA (BOL)
BOSNIA AND HERZEGOVINA (BIH)
BOTSWANA (BWA)
BOUVET ISLAND (BVT)
BRAZIL (BRA)
BRITISH INDIAN OCEAN TERRITORY (IOT)
BRUNEI (BRN)
BULGARIA (BGR)
BURKINA FASO (BFA)
BURMA (BUR)
BURUNDI (BDI)
CAMBODIA (KHM)
CAMEROON (CMR)
CANADA (CAN)
CANTON AND ENDERBURY ISLANDS (CTE)
CAPE VERDE (CPV)
CAYMAN ISLANDS (CYM)
CENTRAL AFRICAN REPUBLIC (CAF)
CHAD (TCD)
CHILE (CHL)
CHINA (CHN)
CHRISTMAS ISLAND (CXR)
COCOS (KEELING) ISLANDS (CCK)
COLOMBIA (COL)
COMOROS (COM)
CONGO (COG)
COOK ISLANDS (COK)
COSTA RICA (CRI)
COTE D'IVOIRE (CIV)
CROATIA (HRV)
CUBA (CUB)
CYPRUS (CYP)
CZECH REPUBLIC (CZE)
DEMOCRATIC YEMEN (YMD)
DENMARK (DNK)
DJIBOUTI (DJI)
DOMINICA (DMA)
DOMINICAN REPUBLIC (DOM)
DRONNING MAUD LAND (DML)
EAST TIMOR (TMP)
ECUADOR (ECU)
EGYPT (EGY)
EL SALVADOR (SLV)
EQUATORIAL GUINEA (GNQ)
ERITREA (ERI)
ESTONIA (EST)
ETHIOPIA (ETH)
FALKLAND ISLANDS (FLK)
FAROE ISLANDS (FRO)
FIJI (FJI)
FINLAND (FIN)
FRANCE (FRA)
FRANCE METROPOLITAN (FXX)
FRENCH GUIANA (GUF)
FRENCH POLYNESIA (PYF)
FRENCH SOUTHERN TERRITORIES (ATF)
GABON (GAB)
GAMBIA (GMB)
GEORGIA (GEO)
GERMANY (DEU)
GHANA (GHA)
GIBRALTAR (GIB)
GREECE (GRC)
GREENLAND (GRL)
GRENADA (GRD)
GUADELOUPE (GLP)
GUAM (GUM)
GUATEMALA (GTM)
GUINEA (GIN)
GUINEA-BISSAU (GNB)
GUYANA (GUY)
HAITI (HTI)
HEARD AND MC DONALD ISLANDS (HMD)
HONDURAS (HND)
HONG KONG (HKG)
HUNGARY (HUN)
ICELAND (ISL)
INDIA (IND)
INDONESIA (IDN)
IRAN (IRN)
IRAQ (IRQ)
IRELAND (IRL)
ISRAEL (ISR)
ITALY (ITA)
JAMAICA (JAM)
JAPAN (JPN)
JOHNSTON ISLAND (JTN)
JORDAN (JOR)
KAZAKHSTAN (KAZ)
KENYA (KEN)
KIRIBATI (KIR)
KOSOVO (KVV)
KUWAIT (KWT)
KYRGYZSTAN (KGZ)
LAOS (LAO)
LATVIA (LVA)
LEBANON (LBN)
LESOTHO (LSO)
LIBERIA (LBR)
LIBYA (LBY)
LIECHTENSTEIN (LIE)
LITHUANIA (LTU)
LUXEMBOURG (LUX)
MACAU (MAC)
MACEDONIA (MKD)
MADAGASCAR (MDG)
MALAWI (MWI)
MALAYSIA (MYS)
MALDIVES (MDV)
MALI (MLI)
MALTA (MLT)
MARSHALL ISLANDS (MHL)
MARTINIQUE (MTQ)
MAURITANIA (MRT)
MAURITIUS (MUS)
MAYOTTE (MYT)
MEXICO (MEX)
MICRONESIA - FEDERATED STATES OF (FSM)
MIDWAY ISLANDS (MID)
MOLDOVA (MDA)
MONACO (MCO)
MONGOLIA (MNG)
MONTSERRAT (MSR)
MOROCCO (MAR)
MOZAMBIQUE (MOZ)
MYANMAR (MMR)
NAMIBIA (NAM)
NAURU (NRU)
NEPAL (NPL)
NETHERLANDS (NLD)
NETHERLANDS ANTILLES (ANT)
NEUTRAL ZONE (NTZ)
NEW CALEDONIA (NCL)
NEW ZEALAND (NZL)
NICARAGUA (NIC)
NIGER (NER)
NIGERIA (NGA)
NIUE (NIU)
NORFOLK ISLAND (NFK)
NORTH KOREA (PRK)
NORTHERN MARIANA ISLANDS (MNP)
NORWAY (NOR)
OMAN (OMN)
PAKISTAN (PAK)
PALAU (PLW)
PALESTINIAN TERRITORIES (PSE)
PANAMA (PAN)
PAPUA NEW GUINEA (PNG)
PARAGUAY (PRY)
PERU (PER)
PHILIPPINES (PHL)
PITCAIRN ISLANDS (PCN)
POLAND (POL)
PORTUGAL (PRT)
PUERTO RICO (PRI)
QATAR (QAT)
REUNION (REU)
ROMANIA (ROM)
RUSSIA (RUS)
RWANDA (RWA)
SAINT KITTS AND NEVIS (KNA)
SAINT LUCIA (LCA)
SAINT VINCENT AND THE GRENADINES (VCT)
SAMOA (WSM)
SAN MARINO (SMR)
SAO TOME AND PRINCIPE (STP)
SAUDI ARABIA (SAU)
SENEGAL (SEN)
SERBIA (SRB)
SERBIA AND MONTENEGRO (SCG)
SEYCHELLES (SYC)
SIERRA LEONE (SLE)
SINGAPORE (SGP)
SLOVAKIA (SVK)
SLOVENIA (SVN)
SOLOMON ISLANDS (SLB)
SOMALIA (SOM)
SOUTH AFRICA (ZAF)
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS (SGS)
SOUTH KOREA (KOR)
SPAIN (ESP)
SRI LANKA (LKA)
ST. HELENA (SHN)
ST. PIERRE AND MIQUELON (SPM)
SUDAN (SDN)
SURINAME (SUR)
SVALBARD AND JAN MAYEN ISLANDS (SJM)
SWAZILAND (SWZ)
SWEDEN (SWE)
SWITZERLAND (CHE)
SYRIA (SYR)
TAIWAN (TWN)
TAJIKISTAN (TJK)
TANZANIA (TZA)
THAILAND (THA)
TIMOR-LESTE (TLS)
TOGO (TGO)
TOKELAU (TKL)
TONGA (TON)
TRINIDAD AND TOBAGO (TTO)
TUNISIA (TUN)
TURKEY (TUR)
TURKMENISTAN (TKM)
TURKS AND CAICOS ISLANDS (TCA)
TUVALU (TUV)
UGANDA (UGA)
UKRAINE (UKR)
UNITED ARAB EMIRATES (ARE)
UNITED KINGDOM (GBR)
UNITED STATES (USA)
UNITED STATES MINOR OUTLYING ISLANDS (UMI)
URUGUAY (URY)
UZBEKISTAN (UZB)
VANUATU (VUT)
VATICAN CITY STATE (HOLY SEE) (VAT)
VENEZUELA (VEN)
VIETNAM (VNM)
VIRGIN ISLANDS (BRITISH) (VGB)
VIRGIN ISLANDS (U.S.) (VIR)
WAKE ISLAND (WAK)
WALLIS AND FUTUNA ISLANDS (WLF)
WESTERN SAHARA (ESH)
YEMEN (YEM)
ZAIRE (ZAR)
ZAMBIA (ZMB)
ZIMBABWE (ZWE)
City of Birth
*
Enter the city, town, village, or hamlet in which you were born. The city, town, village, or hamlet where you were born is required to complete the application. If you do not know the city in which you were born, enter UNKNOWN.
Country of birth
*
Choose the country in which you were born. The country where you were born is required to complete the application.
AFGHANISTAN (AFG)
ALBANIA (ALB)
ALGERIA (DZA)
AMERICAN SAMOA (ASM)
ANDORRA (AND)
ANGOLA (AGO)
ANGUILLA (AIA)
ANTARCTICA (ATA)
ANTIGUA AND BARBUDA (ATG)
ARGENTINA (ARG)
ARMENIA (ARM)
ARUBA (ABW)
AUSTRALIA (AUS)
AUSTRIA (AUT)
AZERBAIJAN (AZE)
BAHAMAS (BHS)
BAHRAIN (BHR)
BANGLADESH (BGD)
BARBADOS (BRB)
BELARUS (BLR)
BELGIUM (BEL)
BELIZE (BLZ)
BENIN (BEN)
BERMUDA (BMU)
BHUTAN (BTN)
BOLIVIA (BOL)
BOSNIA AND HERZEGOVINA (BIH)
BOTSWANA (BWA)
BOUVET ISLAND (BVT)
BRAZIL (BRA)
BRITISH INDIAN OCEAN TERRITORY (IOT)
BRUNEI (BRN)
BULGARIA (BGR)
BURKINA FASO (BFA)
BURMA (BUR)
BURUNDI (BDI)
CAMBODIA (KHM)
CAMEROON (CMR)
CANADA (CAN)
CANTON AND ENDERBURY ISLANDS (CTE)
CAPE VERDE (CPV)
CAYMAN ISLANDS (CYM)
CENTRAL AFRICAN REPUBLIC (CAF)
CHAD (TCD)
CHILE (CHL)
CHINA (CHN)
CHRISTMAS ISLAND (CXR)
COCOS (KEELING) ISLANDS (CCK)
COLOMBIA (COL)
COMOROS (COM)
CONGO (COG)
COOK ISLANDS (COK)
COSTA RICA (CRI)
COTE D'IVOIRE (CIV)
CROATIA (HRV)
CUBA (CUB)
CYPRUS (CYP)
CZECH REPUBLIC (CZE)
DEMOCRATIC YEMEN (YMD)
DENMARK (DNK)
DJIBOUTI (DJI)
DOMINICA (DMA)
DOMINICAN REPUBLIC (DOM)
DRONNING MAUD LAND (DML)
EAST TIMOR (TMP)
ECUADOR (ECU)
EGYPT (EGY)
EL SALVADOR (SLV)
EQUATORIAL GUINEA (GNQ)
ERITREA (ERI)
ESTONIA (EST)
ETHIOPIA (ETH)
FALKLAND ISLANDS (FLK)
FAROE ISLANDS (FRO)
FIJI (FJI)
FINLAND (FIN)
FRANCE (FRA)
FRANCE METROPOLITAN (FXX)
FRENCH GUIANA (GUF)
FRENCH POLYNESIA (PYF)
FRENCH SOUTHERN TERRITORIES (ATF)
GABON (GAB)
GAMBIA (GMB)
GEORGIA (GEO)
GERMANY (DEU)
GHANA (GHA)
GIBRALTAR (GIB)
GREECE (GRC)
GREENLAND (GRL)
GRENADA (GRD)
GUADELOUPE (GLP)
GUAM (GUM)
GUATEMALA (GTM)
GUINEA (GIN)
GUINEA-BISSAU (GNB)
GUYANA (GUY)
HAITI (HTI)
HEARD AND MC DONALD ISLANDS (HMD)
HONDURAS (HND)
HONG KONG (HKG)
HUNGARY (HUN)
ICELAND (ISL)
INDIA (IND)
INDONESIA (IDN)
IRAN (IRN)
IRAQ (IRQ)
IRELAND (IRL)
ISRAEL (ISR)
ITALY (ITA)
JAMAICA (JAM)
JAPAN (JPN)
JOHNSTON ISLAND (JTN)
JORDAN (JOR)
KAZAKHSTAN (KAZ)
KENYA (KEN)
KIRIBATI (KIR)
KOSOVO (KVV)
KUWAIT (KWT)
KYRGYZSTAN (KGZ)
LAOS (LAO)
LATVIA (LVA)
LEBANON (LBN)
LESOTHO (LSO)
LIBERIA (LBR)
LIBYA (LBY)
LIECHTENSTEIN (LIE)
LITHUANIA (LTU)
LUXEMBOURG (LUX)
MACAU (MAC)
MACEDONIA (MKD)
MADAGASCAR (MDG)
MALAWI (MWI)
MALAYSIA (MYS)
MALDIVES (MDV)
MALI (MLI)
MALTA (MLT)
MARSHALL ISLANDS (MHL)
MARTINIQUE (MTQ)
MAURITANIA (MRT)
MAURITIUS (MUS)
MAYOTTE (MYT)
MEXICO (MEX)
MICRONESIA - FEDERATED STATES OF (FSM)
MIDWAY ISLANDS (MID)
MOLDOVA (MDA)
MONACO (MCO)
MONGOLIA (MNG)
MONTSERRAT (MSR)
MOROCCO (MAR)
MOZAMBIQUE (MOZ)
MYANMAR (MMR)
NAMIBIA (NAM)
NAURU (NRU)
NEPAL (NPL)
NETHERLANDS (NLD)
NETHERLANDS ANTILLES (ANT)
NEUTRAL ZONE (NTZ)
NEW CALEDONIA (NCL)
NEW ZEALAND (NZL)
NICARAGUA (NIC)
NIGER (NER)
NIGERIA (NGA)
NIUE (NIU)
NORFOLK ISLAND (NFK)
NORTH KOREA (PRK)
NORTHERN MARIANA ISLANDS (MNP)
NORWAY (NOR)
OMAN (OMN)
PAKISTAN (PAK)
PALAU (PLW)
PALESTINIAN TERRITORIES (PSE)
PANAMA (PAN)
PAPUA NEW GUINEA (PNG)
PARAGUAY (PRY)
PERU (PER)
PHILIPPINES (PHL)
PITCAIRN ISLANDS (PCN)
POLAND (POL)
PORTUGAL (PRT)
PUERTO RICO (PRI)
QATAR (QAT)
REUNION (REU)
ROMANIA (ROM)
RUSSIA (RUS)
RWANDA (RWA)
SAINT KITTS AND NEVIS (KNA)
SAINT LUCIA (LCA)
SAINT VINCENT AND THE GRENADINES (VCT)
SAMOA (WSM)
SAN MARINO (SMR)
SAO TOME AND PRINCIPE (STP)
SAUDI ARABIA (SAU)
SENEGAL (SEN)
SERBIA (SRB)
SERBIA AND MONTENEGRO (SCG)
SEYCHELLES (SYC)
SIERRA LEONE (SLE)
SINGAPORE (SGP)
SLOVAKIA (SVK)
SLOVENIA (SVN)
SOLOMON ISLANDS (SLB)
SOMALIA (SOM)
SOUTH AFRICA (ZAF)
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS (SGS)
SOUTH KOREA (KOR)
SPAIN (ESP)
SRI LANKA (LKA)
ST. HELENA (SHN)
ST. PIERRE AND MIQUELON (SPM)
SUDAN (SDN)
SURINAME (SUR)
SVALBARD AND JAN MAYEN ISLANDS (SJM)
SWAZILAND (SWZ)
SWEDEN (SWE)
SWITZERLAND (CHE)
SYRIA (SYR)
TAIWAN (TWN)
TAJIKISTAN (TJK)
TANZANIA (TZA)
THAILAND (THA)
TIMOR-LESTE (TLS)
TOGO (TGO)
TOKELAU (TKL)
TONGA (TON)
TRINIDAD AND TOBAGO (TTO)
TUNISIA (TUN)
TURKEY (TUR)
TURKMENISTAN (TKM)
TURKS AND CAICOS ISLANDS (TCA)
TUVALU (TUV)
UGANDA (UGA)
UKRAINE (UKR)
UNITED ARAB EMIRATES (ARE)
UNITED KINGDOM (GBR)
UNITED STATES (USA)
UNITED STATES MINOR OUTLYING ISLANDS (UMI)
URUGUAY (URY)
UZBEKISTAN (UZB)
VANUATU (VUT)
VATICAN CITY STATE (HOLY SEE) (VAT)
VENEZUELA (VEN)
VIETNAM (VNM)
VIRGIN ISLANDS (BRITISH) (VGB)
VIRGIN ISLANDS (U.S.) (VIR)
WAKE ISLAND (WAK)
WALLIS AND FUTUNA ISLANDS (WLF)
WESTERN SAHARA (ESH)
YEMEN (YEM)
ZAIRE (ZAR)
ZAMBIA (ZMB)
ZIMBABWE (ZWE)
Residential country
*
Choose the country in which you reside. The country where you live is required to complete the application.
AFGHANISTAN (AFG)
ALBANIA (ALB)
ALGERIA (DZA)
AMERICAN SAMOA (ASM)
ANDORRA (AND)
ANGOLA (AGO)
ANGUILLA (AIA)
ANTARCTICA (ATA)
ANTIGUA AND BARBUDA (ATG)
ARGENTINA (ARG)
ARMENIA (ARM)
ARUBA (ABW)
AUSTRALIA (AUS)
AUSTRIA (AUT)
AZERBAIJAN (AZE)
BAHAMAS (BHS)
BAHRAIN (BHR)
BANGLADESH (BGD)
BARBADOS (BRB)
BELARUS (BLR)
BELGIUM (BEL)
BELIZE (BLZ)
BENIN (BEN)
BERMUDA (BMU)
BHUTAN (BTN)
BOLIVIA (BOL)
BOSNIA AND HERZEGOVINA (BIH)
BOTSWANA (BWA)
BOUVET ISLAND (BVT)
BRAZIL (BRA)
BRITISH INDIAN OCEAN TERRITORY (IOT)
BRUNEI (BRN)
BULGARIA (BGR)
BURKINA FASO (BFA)
BURMA (BUR)
BURUNDI (BDI)
CAMBODIA (KHM)
CAMEROON (CMR)
CANADA (CAN)
CANTON AND ENDERBURY ISLANDS (CTE)
CAPE VERDE (CPV)
CAYMAN ISLANDS (CYM)
CENTRAL AFRICAN REPUBLIC (CAF)
CHAD (TCD)
CHILE (CHL)
CHINA (CHN)
CHRISTMAS ISLAND (CXR)
COCOS (KEELING) ISLANDS (CCK)
COLOMBIA (COL)
COMOROS (COM)
CONGO (COG)
COOK ISLANDS (COK)
COSTA RICA (CRI)
COTE D'IVOIRE (CIV)
CROATIA (HRV)
CUBA (CUB)
CYPRUS (CYP)
CZECH REPUBLIC (CZE)
DEMOCRATIC YEMEN (YMD)
DENMARK (DNK)
DJIBOUTI (DJI)
DOMINICA (DMA)
DOMINICAN REPUBLIC (DOM)
DRONNING MAUD LAND (DML)
EAST TIMOR (TMP)
ECUADOR (ECU)
EGYPT (EGY)
EL SALVADOR (SLV)
EQUATORIAL GUINEA (GNQ)
ERITREA (ERI)
ESTONIA (EST)
ETHIOPIA (ETH)
FALKLAND ISLANDS (FLK)
FAROE ISLANDS (FRO)
FIJI (FJI)
FINLAND (FIN)
FRANCE (FRA)
FRANCE METROPOLITAN (FXX)
FRENCH GUIANA (GUF)
FRENCH POLYNESIA (PYF)
FRENCH SOUTHERN TERRITORIES (ATF)
GABON (GAB)
GAMBIA (GMB)
GEORGIA (GEO)
GERMANY (DEU)
GHANA (GHA)
GIBRALTAR (GIB)
GREECE (GRC)
GREENLAND (GRL)
GRENADA (GRD)
GUADELOUPE (GLP)
GUAM (GUM)
GUATEMALA (GTM)
GUINEA (GIN)
GUINEA-BISSAU (GNB)
GUYANA (GUY)
HAITI (HTI)
HEARD AND MC DONALD ISLANDS (HMD)
HONDURAS (HND)
HONG KONG (HKG)
HUNGARY (HUN)
ICELAND (ISL)
INDIA (IND)
INDONESIA (IDN)
IRAN (IRN)
IRAQ (IRQ)
IRELAND (IRL)
ISRAEL (ISR)
ITALY (ITA)
JAMAICA (JAM)
JAPAN (JPN)
JOHNSTON ISLAND (JTN)
JORDAN (JOR)
KAZAKHSTAN (KAZ)
KENYA (KEN)
KIRIBATI (KIR)
KOSOVO (KVV)
KUWAIT (KWT)
KYRGYZSTAN (KGZ)
LAOS (LAO)
LATVIA (LVA)
LEBANON (LBN)
LESOTHO (LSO)
LIBERIA (LBR)
LIBYA (LBY)
LIECHTENSTEIN (LIE)
LITHUANIA (LTU)
LUXEMBOURG (LUX)
MACAU (MAC)
MACEDONIA (MKD)
MADAGASCAR (MDG)
MALAWI (MWI)
MALAYSIA (MYS)
MALDIVES (MDV)
MALI (MLI)
MALTA (MLT)
MARSHALL ISLANDS (MHL)
MARTINIQUE (MTQ)
MAURITANIA (MRT)
MAURITIUS (MUS)
MAYOTTE (MYT)
MEXICO (MEX)
MICRONESIA - FEDERATED STATES OF (FSM)
MIDWAY ISLANDS (MID)
MOLDOVA (MDA)
MONACO (MCO)
MONGOLIA (MNG)
MONTSERRAT (MSR)
MOROCCO (MAR)
MOZAMBIQUE (MOZ)
MYANMAR (MMR)
NAMIBIA (NAM)
NAURU (NRU)
NEPAL (NPL)
NETHERLANDS (NLD)
NETHERLANDS ANTILLES (ANT)
NEUTRAL ZONE (NTZ)
NEW CALEDONIA (NCL)
NEW ZEALAND (NZL)
NICARAGUA (NIC)
NIGER (NER)
NIGERIA (NGA)
NIUE (NIU)
NORFOLK ISLAND (NFK)
NORTH KOREA (PRK)
NORTHERN MARIANA ISLANDS (MNP)
NORWAY (NOR)
OMAN (OMN)
PAKISTAN (PAK)
PALAU (PLW)
PALESTINIAN TERRITORIES (PSE)
PANAMA (PAN)
PAPUA NEW GUINEA (PNG)
PARAGUAY (PRY)
PERU (PER)
PHILIPPINES (PHL)
PITCAIRN ISLANDS (PCN)
POLAND (POL)
PORTUGAL (PRT)
PUERTO RICO (PRI)
QATAR (QAT)
REUNION (REU)
ROMANIA (ROM)
RUSSIA (RUS)
RWANDA (RWA)
SAINT KITTS AND NEVIS (KNA)
SAINT LUCIA (LCA)
SAINT VINCENT AND THE GRENADINES (VCT)
SAMOA (WSM)
SAN MARINO (SMR)
SAO TOME AND PRINCIPE (STP)
SAUDI ARABIA (SAU)
SENEGAL (SEN)
SERBIA (SRB)
SERBIA AND MONTENEGRO (SCG)
SEYCHELLES (SYC)
SIERRA LEONE (SLE)
SINGAPORE (SGP)
SLOVAKIA (SVK)
SLOVENIA (SVN)
SOLOMON ISLANDS (SLB)
SOMALIA (SOM)
SOUTH AFRICA (ZAF)
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS (SGS)
SOUTH KOREA (KOR)
SPAIN (ESP)
SRI LANKA (LKA)
ST. HELENA (SHN)
ST. PIERRE AND MIQUELON (SPM)
SUDAN (SDN)
SURINAME (SUR)
SVALBARD AND JAN MAYEN ISLANDS (SJM)
SWAZILAND (SWZ)
SWEDEN (SWE)
SWITZERLAND (CHE)
SYRIA (SYR)
TAIWAN (TWN)
TAJIKISTAN (TJK)
TANZANIA (TZA)
THAILAND (THA)
TIMOR-LESTE (TLS)
TOGO (TGO)
TOKELAU (TKL)
TONGA (TON)
TRINIDAD AND TOBAGO (TTO)
TUNISIA (TUN)
TURKEY (TUR)
TURKMENISTAN (TKM)
TURKS AND CAICOS ISLANDS (TCA)
TUVALU (TUV)
UGANDA (UGA)
UKRAINE (UKR)
UNITED ARAB EMIRATES (ARE)
UNITED KINGDOM (GBR)
UNITED STATES (USA)
UNITED STATES MINOR OUTLYING ISLANDS (UMI)
URUGUAY (URY)
UZBEKISTAN (UZB)
VANUATU (VUT)
VATICAN CITY STATE (HOLY SEE) (VAT)
VENEZUELA (VEN)
VIETNAM (VNM)
VIRGIN ISLANDS (BRITISH) (VGB)
VIRGIN ISLANDS (U.S.) (VIR)
WAKE ISLAND (WAK)
WALLIS AND FUTUNA ISLANDS (WLF)
WESTERN SAHARA (ESH)
YEMEN (YEM)
ZAIRE (ZAR)
ZAMBIA (ZMB)
ZIMBABWE (ZWE)
Are you a citizen of any other country?
*
Indicate whether you are a citizen of any other country. Answering this question is required to complete your application.
Yes
No
Other Citizenship
*
In the Country field, choose the country of your other citizenship(s). If you answered yes above, the country is required to complete your application. In the Passport Number field, enter your passport number as it appears in your other passport(s). The passport number may contain numbers and/or characters. Please closely distinguish between the two, such as the numbers zero and one, and the letters O and I. The passport number is optional to complete your application.
Country
AFGHANISTAN (AFG)
ALBANIA (ALB)
ALGERIA (DZA)
AMERICAN SAMOA (ASM)
ANDORRA (AND)
ANGOLA (AGO)
ANGUILLA (AIA)
ANTARCTICA (ATA)
ANTIGUA AND BARBUDA (ATG)
ARGENTINA (ARG)
ARMENIA (ARM)
ARUBA (ABW)
AUSTRALIA (AUS)
AUSTRIA (AUT)
AZERBAIJAN (AZE)
BAHAMAS (BHS)
BAHRAIN (BHR)
BANGLADESH (BGD)
BARBADOS (BRB)
BELARUS (BLR)
BELGIUM (BEL)
BELIZE (BLZ)
BENIN (BEN)
BERMUDA (BMU)
BHUTAN (BTN)
BOLIVIA (BOL)
BOSNIA AND HERZEGOVINA (BIH)
BOTSWANA (BWA)
BOUVET ISLAND (BVT)
BRAZIL (BRA)
BRITISH INDIAN OCEAN TERRITORY (IOT)
BRUNEI (BRN)
BULGARIA (BGR)
BURKINA FASO (BFA)
BURMA (BUR)
BURUNDI (BDI)
CAMBODIA (KHM)
CAMEROON (CMR)
CANADA (CAN)
CANTON AND ENDERBURY ISLANDS (CTE)
CAPE VERDE (CPV)
CAYMAN ISLANDS (CYM)
CENTRAL AFRICAN REPUBLIC (CAF)
CHAD (TCD)
CHILE (CHL)
CHINA (CHN)
CHRISTMAS ISLAND (CXR)
COCOS (KEELING) ISLANDS (CCK)
COLOMBIA (COL)
COMOROS (COM)
CONGO (COG)
COOK ISLANDS (COK)
COSTA RICA (CRI)
COTE D'IVOIRE (CIV)
CROATIA (HRV)
CUBA (CUB)
CYPRUS (CYP)
CZECH REPUBLIC (CZE)
DEMOCRATIC YEMEN (YMD)
DENMARK (DNK)
DJIBOUTI (DJI)
DOMINICA (DMA)
DOMINICAN REPUBLIC (DOM)
DRONNING MAUD LAND (DML)
EAST TIMOR (TMP)
ECUADOR (ECU)
EGYPT (EGY)
EL SALVADOR (SLV)
EQUATORIAL GUINEA (GNQ)
ERITREA (ERI)
ESTONIA (EST)
ETHIOPIA (ETH)
FALKLAND ISLANDS (FLK)
FAROE ISLANDS (FRO)
FIJI (FJI)
FINLAND (FIN)
FRANCE (FRA)
FRANCE METROPOLITAN (FXX)
FRENCH GUIANA (GUF)
FRENCH POLYNESIA (PYF)
FRENCH SOUTHERN TERRITORIES (ATF)
GABON (GAB)
GAMBIA (GMB)
GEORGIA (GEO)
GERMANY (DEU)
GHANA (GHA)
GIBRALTAR (GIB)
GREECE (GRC)
GREENLAND (GRL)
GRENADA (GRD)
GUADELOUPE (GLP)
GUAM (GUM)
GUATEMALA (GTM)
GUINEA (GIN)
GUINEA-BISSAU (GNB)
GUYANA (GUY)
HAITI (HTI)
HEARD AND MC DONALD ISLANDS (HMD)
HONDURAS (HND)
HONG KONG (HKG)
HUNGARY (HUN)
ICELAND (ISL)
INDIA (IND)
INDONESIA (IDN)
IRAN (IRN)
IRAQ (IRQ)
IRELAND (IRL)
ISRAEL (ISR)
ITALY (ITA)
JAMAICA (JAM)
JAPAN (JPN)
JOHNSTON ISLAND (JTN)
JORDAN (JOR)
KAZAKHSTAN (KAZ)
KENYA (KEN)
KIRIBATI (KIR)
KOSOVO (KVV)
KUWAIT (KWT)
KYRGYZSTAN (KGZ)
LAOS (LAO)
LATVIA (LVA)
LEBANON (LBN)
LESOTHO (LSO)
LIBERIA (LBR)
LIBYA (LBY)
LIECHTENSTEIN (LIE)
LITHUANIA (LTU)
LUXEMBOURG (LUX)
MACAU (MAC)
MACEDONIA (MKD)
MADAGASCAR (MDG)
MALAWI (MWI)
MALAYSIA (MYS)
MALDIVES (MDV)
MALI (MLI)
MALTA (MLT)
MARSHALL ISLANDS (MHL)
MARTINIQUE (MTQ)
MAURITANIA (MRT)
MAURITIUS (MUS)
MAYOTTE (MYT)
MEXICO (MEX)
MICRONESIA - FEDERATED STATES OF (FSM)
MIDWAY ISLANDS (MID)
MOLDOVA (MDA)
MONACO (MCO)
MONGOLIA (MNG)
MONTSERRAT (MSR)
MOROCCO (MAR)
MOZAMBIQUE (MOZ)
MYANMAR (MMR)
NAMIBIA (NAM)
NAURU (NRU)
NEPAL (NPL)
NETHERLANDS (NLD)
NETHERLANDS ANTILLES (ANT)
NEUTRAL ZONE (NTZ)
NEW CALEDONIA (NCL)
NEW ZEALAND (NZL)
NICARAGUA (NIC)
NIGER (NER)
NIGERIA (NGA)
NIUE (NIU)
NORFOLK ISLAND (NFK)
NORTH KOREA (PRK)
NORTHERN MARIANA ISLANDS (MNP)
NORWAY (NOR)
OMAN (OMN)
PAKISTAN (PAK)
PALAU (PLW)
PALESTINIAN TERRITORIES (PSE)
PANAMA (PAN)
PAPUA NEW GUINEA (PNG)
PARAGUAY (PRY)
PERU (PER)
PHILIPPINES (PHL)
PITCAIRN ISLANDS (PCN)
POLAND (POL)
PORTUGAL (PRT)
PUERTO RICO (PRI)
QATAR (QAT)
REUNION (REU)
ROMANIA (ROM)
RUSSIA (RUS)
RWANDA (RWA)
SAINT KITTS AND NEVIS (KNA)
SAINT LUCIA (LCA)
SAINT VINCENT AND THE GRENADINES (VCT)
SAMOA (WSM)
SAN MARINO (SMR)
SAO TOME AND PRINCIPE (STP)
SAUDI ARABIA (SAU)
SENEGAL (SEN)
SERBIA (SRB)
SERBIA AND MONTENEGRO (SCG)
SEYCHELLES (SYC)
SIERRA LEONE (SLE)
SINGAPORE (SGP)
SLOVAKIA (SVK)
SLOVENIA (SVN)
SOLOMON ISLANDS (SLB)
SOMALIA (SOM)
SOUTH AFRICA (ZAF)
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS (SGS)
SOUTH KOREA (KOR)
SPAIN (ESP)
SRI LANKA (LKA)
ST. HELENA (SHN)
ST. PIERRE AND MIQUELON (SPM)
SUDAN (SDN)
SURINAME (SUR)
SVALBARD AND JAN MAYEN ISLANDS (SJM)
SWAZILAND (SWZ)
SWEDEN (SWE)
SWITZERLAND (CHE)
SYRIA (SYR)
TAIWAN (TWN)
TAJIKISTAN (TJK)
TANZANIA (TZA)
THAILAND (THA)
TIMOR-LESTE (TLS)
TOGO (TGO)
TOKELAU (TKL)
TONGA (TON)
TRINIDAD AND TOBAGO (TTO)
TUNISIA (TUN)
TURKEY (TUR)
TURKMENISTAN (TKM)
TURKS AND CAICOS ISLANDS (TCA)
TUVALU (TUV)
UGANDA (UGA)
UKRAINE (UKR)
UNITED ARAB EMIRATES (ARE)
UNITED KINGDOM (GBR)
UNITED STATES (USA)
UNITED STATES MINOR OUTLYING ISLANDS (UMI)
URUGUAY (URY)
UZBEKISTAN (UZB)
VANUATU (VUT)
VATICAN CITY STATE (HOLY SEE) (VAT)
VENEZUELA (VEN)
VIETNAM (VNM)
VIRGIN ISLANDS (BRITISH) (VGB)
VIRGIN ISLANDS (U.S.) (VIR)
WAKE ISLAND (WAK)
WALLIS AND FUTUNA ISLANDS (WLF)
WESTERN SAHARA (ESH)
YEMEN (YEM)
ZAIRE (ZAR)
ZAMBIA (ZMB)
ZIMBABWE (ZWE)
Passport Number
Parents
*
Enter the names of your parents. These are required to complete the application. If you do not know the name of one or both of your parents, enter UNKNOWN, for each parent. This field can include the names of your biological, adoptive, step-parent or guardian. In the Family Name field, enter your parent's family name. The family name is required to complete the application. If you do not know one or both of your parents, enter UNKNOWN. In the First (Given) Name field, enter your parent's first (given) name. Do not include the middle name in this field. The first name is required to complete the application. If your parent has no first name, or if you do not know one or both of your parents, enter UNKNOWN.
Birth Date
Day
*
Choose the day on which you were born. The day of birth is required to complete the application or to check the status of your application.
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
Month
*
Choose the month in which you were born. The month of birth is required to complete the application or to check the status of your application.
January
February
March
April
May
June
July
August
September
October
November
December
Year
*
Choose the year in which you were born. The year of birth is required to complete the application or to check the status of your application.
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
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
Sex
*
Choose your gender, either male or female. The sex (gender) is required to complete the application.
Male
Female
E-Mail Address
*
Enter the e-mail address at which you can be contacted. The e-mail address is optional to complete the application.
Home Address
Address line 1
*
In the Address Line 1 field, enter the number and street of the location of your home address. Do not include the city and state in this field. Address line 1 is required to complete the application.
Address Line 2
City
*
In the City field, enter the city, town, village, or hamlet. The city, town, village, or hamlet is required to complete the application.
Country
*
In the Country field, choose the country. The country is required to complete the application.
AFGHANISTAN (AFG)
ALBANIA (ALB)
ALGERIA (DZA)
AMERICAN SAMOA (ASM)
ANDORRA (AND)
ANGOLA (AGO)
ANGUILLA (AIA)
ANTARCTICA (ATA)
ANTIGUA AND BARBUDA (ATG)
ARGENTINA (ARG)
ARMENIA (ARM)
ARUBA (ABW)
AUSTRALIA (AUS)
AUSTRIA (AUT)
AZERBAIJAN (AZE)
BAHAMAS (BHS)
BAHRAIN (BHR)
BANGLADESH (BGD)
BARBADOS (BRB)
BELARUS (BLR)
BELGIUM (BEL)
BELIZE (BLZ)
BENIN (BEN)
BERMUDA (BMU)
BHUTAN (BTN)
BOLIVIA (BOL)
BOSNIA AND HERZEGOVINA (BIH)
BOTSWANA (BWA)
BOUVET ISLAND (BVT)
BRAZIL (BRA)
BRITISH INDIAN OCEAN TERRITORY (IOT)
BRUNEI (BRN)
BULGARIA (BGR)
BURKINA FASO (BFA)
BURMA (BUR)
BURUNDI (BDI)
CAMBODIA (KHM)
CAMEROON (CMR)
CANADA (CAN)
CANTON AND ENDERBURY ISLANDS (CTE)
CAPE VERDE (CPV)
CAYMAN ISLANDS (CYM)
CENTRAL AFRICAN REPUBLIC (CAF)
CHAD (TCD)
CHILE (CHL)
CHINA (CHN)
CHRISTMAS ISLAND (CXR)
COCOS (KEELING) ISLANDS (CCK)
COLOMBIA (COL)
COMOROS (COM)
CONGO (COG)
COOK ISLANDS (COK)
COSTA RICA (CRI)
COTE D'IVOIRE (CIV)
CROATIA (HRV)
CUBA (CUB)
CYPRUS (CYP)
CZECH REPUBLIC (CZE)
DEMOCRATIC YEMEN (YMD)
DENMARK (DNK)
DJIBOUTI (DJI)
DOMINICA (DMA)
DOMINICAN REPUBLIC (DOM)
DRONNING MAUD LAND (DML)
EAST TIMOR (TMP)
ECUADOR (ECU)
EGYPT (EGY)
EL SALVADOR (SLV)
EQUATORIAL GUINEA (GNQ)
ERITREA (ERI)
ESTONIA (EST)
ETHIOPIA (ETH)
FALKLAND ISLANDS (FLK)
FAROE ISLANDS (FRO)
FIJI (FJI)
FINLAND (FIN)
FRANCE (FRA)
FRANCE METROPOLITAN (FXX)
FRENCH GUIANA (GUF)
FRENCH POLYNESIA (PYF)
FRENCH SOUTHERN TERRITORIES (ATF)
GABON (GAB)
GAMBIA (GMB)
GEORGIA (GEO)
GERMANY (DEU)
GHANA (GHA)
GIBRALTAR (GIB)
GREECE (GRC)
GREENLAND (GRL)
GRENADA (GRD)
GUADELOUPE (GLP)
GUAM (GUM)
GUATEMALA (GTM)
GUINEA (GIN)
GUINEA-BISSAU (GNB)
GUYANA (GUY)
HAITI (HTI)
HEARD AND MC DONALD ISLANDS (HMD)
HONDURAS (HND)
HONG KONG (HKG)
HUNGARY (HUN)
ICELAND (ISL)
INDIA (IND)
INDONESIA (IDN)
IRAN (IRN)
IRAQ (IRQ)
IRELAND (IRL)
ISRAEL (ISR)
ITALY (ITA)
JAMAICA (JAM)
JAPAN (JPN)
JOHNSTON ISLAND (JTN)
JORDAN (JOR)
KAZAKHSTAN (KAZ)
KENYA (KEN)
KIRIBATI (KIR)
KOSOVO (KVV)
KUWAIT (KWT)
KYRGYZSTAN (KGZ)
LAOS (LAO)
LATVIA (LVA)
LEBANON (LBN)
LESOTHO (LSO)
LIBERIA (LBR)
LIBYA (LBY)
LIECHTENSTEIN (LIE)
LITHUANIA (LTU)
LUXEMBOURG (LUX)
MACAU (MAC)
MACEDONIA (MKD)
MADAGASCAR (MDG)
MALAWI (MWI)
MALAYSIA (MYS)
MALDIVES (MDV)
MALI (MLI)
MALTA (MLT)
MARSHALL ISLANDS (MHL)
MARTINIQUE (MTQ)
MAURITANIA (MRT)
MAURITIUS (MUS)
MAYOTTE (MYT)
MEXICO (MEX)
MICRONESIA - FEDERATED STATES OF (FSM)
MIDWAY ISLANDS (MID)
MOLDOVA (MDA)
MONACO (MCO)
MONGOLIA (MNG)
MONTSERRAT (MSR)
MOROCCO (MAR)
MOZAMBIQUE (MOZ)
MYANMAR (MMR)
NAMIBIA (NAM)
NAURU (NRU)
NEPAL (NPL)
NETHERLANDS (NLD)
NETHERLANDS ANTILLES (ANT)
NEUTRAL ZONE (NTZ)
NEW CALEDONIA (NCL)
NEW ZEALAND (NZL)
NICARAGUA (NIC)
NIGER (NER)
NIGERIA (NGA)
NIUE (NIU)
NORFOLK ISLAND (NFK)
NORTH KOREA (PRK)
NORTHERN MARIANA ISLANDS (MNP)
NORWAY (NOR)
OMAN (OMN)
PAKISTAN (PAK)
PALAU (PLW)
PALESTINIAN TERRITORIES (PSE)
PANAMA (PAN)
PAPUA NEW GUINEA (PNG)
PARAGUAY (PRY)
PERU (PER)
PHILIPPINES (PHL)
PITCAIRN ISLANDS (PCN)
POLAND (POL)
PORTUGAL (PRT)
PUERTO RICO (PRI)
QATAR (QAT)
REUNION (REU)
ROMANIA (ROM)
RUSSIA (RUS)
RWANDA (RWA)
SAINT KITTS AND NEVIS (KNA)
SAINT LUCIA (LCA)
SAINT VINCENT AND THE GRENADINES (VCT)
SAMOA (WSM)
SAN MARINO (SMR)
SAO TOME AND PRINCIPE (STP)
SAUDI ARABIA (SAU)
SENEGAL (SEN)
SERBIA (SRB)
SERBIA AND MONTENEGRO (SCG)
SEYCHELLES (SYC)
SIERRA LEONE (SLE)
SINGAPORE (SGP)
SLOVAKIA (SVK)
SLOVENIA (SVN)
SOLOMON ISLANDS (SLB)
SOMALIA (SOM)
SOUTH AFRICA (ZAF)
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS (SGS)
SOUTH KOREA (KOR)
SPAIN (ESP)
SRI LANKA (LKA)
ST. HELENA (SHN)
ST. PIERRE AND MIQUELON (SPM)
SUDAN (SDN)
SURINAME (SUR)
SVALBARD AND JAN MAYEN ISLANDS (SJM)
SWAZILAND (SWZ)
SWEDEN (SWE)
SWITZERLAND (CHE)
SYRIA (SYR)
TAIWAN (TWN)
TAJIKISTAN (TJK)
TANZANIA (TZA)
THAILAND (THA)
TIMOR-LESTE (TLS)
TOGO (TGO)
TOKELAU (TKL)
TONGA (TON)
TRINIDAD AND TOBAGO (TTO)
TUNISIA (TUN)
TURKEY (TUR)
TURKMENISTAN (TKM)
TURKS AND CAICOS ISLANDS (TCA)
TUVALU (TUV)
UGANDA (UGA)
UKRAINE (UKR)
UNITED ARAB EMIRATES (ARE)
UNITED KINGDOM (GBR)
UNITED STATES (USA)
UNITED STATES MINOR OUTLYING ISLANDS (UMI)
URUGUAY (URY)
UZBEKISTAN (UZB)
VANUATU (VUT)
VATICAN CITY STATE (HOLY SEE) (VAT)
VENEZUELA (VEN)
VIETNAM (VNM)
VIRGIN ISLANDS (BRITISH) (VGB)
VIRGIN ISLANDS (U.S.) (VIR)
WAKE ISLAND (WAK)
WALLIS AND FUTUNA ISLANDS (WLF)
WESTERN SAHARA (ESH)
YEMEN (YEM)
ZAIRE (ZAR)
ZAMBIA (ZMB)
ZIMBABWE (ZWE)
Telephone Number
Country Code
*
Choose the country code of the telephone number where you can be contacted. The country code and telephone number are optional to complete the application.
Afghanistan (+93)
Albania (+355)
Algeria (+213)
American Samoa (+1684)
Andorra (+376)
Angola (+244)
Anguilla (+1264)
Norfolk Island (+672)
Barbuda (+1268)
Argentina (+54)
Armenia (+374)
Aruba (+297)
Ascension (+247)
Australia (+61)
Austria (+43)
Azerbaijan (+994)
Bahamas (+1242)
Bahrain (+973)
Bangladesh (+880)
Barbados (+1246)
Belarus (+375)
Belgium (+32)
Belize (+501)
Benin (+229)
Bermuda (+1441)
Bhutan (+975)
Bolivia (+591)
Bosnia & Herzegovina (+387)
Botswana (+267)
Brazil (+55)
Brunei Darussalam (+673)
Bulgaria (+359)
Burkina Faso (+226)
Burundi (+257)
C?d'Ivoire (+225)
Cambodia (+855)
Cameroon (+237)
United States of America (+1)
Cape Verde Islands (+238)
Cayman Islands (+1345)
Central African Republic (+236)
Chad (+235)
New Zealand (+64)
Easter Island (+56)
China (PRC) (+86)
Cuba (+53)
Colombia (+57)
Mayotte Island (+269)
Congo (+242)
Congo, Dem. Rep. of (former Zaire) (+243)
Cook Islands (+682)
Costa Rica (+506)
Croatia (+385)
Netherlands Antilles (+599)
Cyprus (+357)
Czech Republic (+420)
Denmark (+45)
Diego Garcia (+246)
Djibouti (+253)
Dominica (+1767)
Dominican Republic (+1809)
Dominican Republic (+1829)
Northern Marianas Islands (+670)
Ecuador (+593)
Egypt (+20)
El Salvador (+503)
Equatorial Guinea (+240)
Eritrea (+291)
Estonia (+372)
Ethiopia (+251)
Falkland Islands (Malvinas) (+500)
Faroe Islands (+298)
Fiji Islands (+679)
Finland (+358)
France (+33)
Martinique (+596)
French Guiana (+594)
French Polynesia (+689)
Gabonese Republic (+241)
Gambia (+220)
Georgia (+995)
Germany (+49)
Ghana (+233)
Gibraltar (+350)
Greece (+30)
Greenland (+299)
Grenada (+1473)
Guadeloupe (+590)
Guam (+1671)
Guatemala (+502)
Guinea (+224)
Guinea-Bissau (+245)
Guyana (+592)
Haiti (+509)
Honduras (+504)
Hong Kong (+852)
Hungary (+36)
Iceland (+354)
India (+91)
Indonesia (+62)
Iran (+98)
Iraq (+964)
Ireland (+353)
Israel (+972)
Italy (+39)
Jamaica (+1876)
Japan (+81)
Jordan (+962)
Russia (+7)
Kenya (+254)
Kiribati (+686)
Korea (North) (+850)
Korea (South) (+82)
Kuwait (+965)
Kyrgyz Republic (+996)
Laos (+856)
Latvia (+371)
Lebanon (+961)
Lesotho (+266)
Liberia (+231)
Libya (+218)
Liechtenstein (+423)
Lithuania (+370)
Luxembourg (+352)
Macao (+853)
Macedonia (Former Yugoslav Rep. of) (+389)
Madagascar (+261)
Malawi (+265)
Malaysia (+60)
Maldives (+960)
Mali Republic (+223)
Malta (+356)
Marshall Islands (+692)
Mauritania (+222)
Mauritius (+230)
Mexico (+52)
Micronesia (Federal States of) (+691)
Midway Island (+1808)
Moldova (+373)
Monaco (+377)
Mongolia (+976)
Montenegro (+382)
Montserrat (+1664)
Morocco (+212)
Mozambique (+258)
Myanmar (+95)
Namibia (+264)
Nauru (+674)
Nepal (+977)
Netherlands (+31)
St. Kitts (+1869)
New Caledonia (+687)
Nicaragua (+505)
Niger (+227)
Nigeria (+234)
Niue (+683)
Norway (+47)
Oman (+968)
Pakistan (+92)
Palestinian Settlements (+970)
Panama (+507)
Papua New Guinea (+675)
Paraguay (+595)
Peru (+51)
Philippines (+63)
Poland (+48)
Portugal (+351)
Puerto Rico (+1787)
Puerto Rico (+1939)
Qatar (+974)
R?ion (+262)
Romania (+40)
Rwandese Republic (+250)
S?Tom?amp; Pr?ipe (+239)
Samoa (+685)
San Marino (+378)
Saudi Arabia (+966)
Senegal (+221)
Yugoslavia (+381)
Seychelles Republic (+248)
Sierra Leone (+232)
Singapore (+65)
Slovak Republic (+421)
Slovenia (+386)
Solomon Islands (+677)
Somali Democratic Republic (+252)
South Africa (+27)
Spain (+34)
Sri Lanka (+94)
St. Helena (+290)
St. Lucia (+1758)
St. Pierre & Miquelon (+508)
St. Vincent & Grenadines (+784)
Sudan (+249)
Suriname (+597)
Swaziland (+268)
Sweden (+46)
Switzerland (+41)
Syria (+963)
Taiwan (+886)
Tajikistan (+992)
Zanzibar (+255)
Thailand (+66)
Togolese Republic (+228)
Tokelau (+690)
Tonga Islands (+676)
Trinidad & Tobago (+1868)
Tunisia (+216)
Turkey (+90)
Turkmenistan (+993)
Turks & Caicos Islands (+1649)
Tuvalu (+688)
Uganda (+256)
Ukraine (+380)
United Arab Emirates (+971)
United Kingdom (+44)
Uruguay (+598)
Uzbekistan (+998)
Vanuatu (+678)
Vatican City (+379)
Venezuela (+58)
Vietnam (+84)
Virgin Islands - British (+1284)
Virgin Islands - US (+1340)
Wake Island (+808)
Wallis & Futuna (+681)
Yemen (North) (+969)
Yemen (South) (+967)
Zambia (+260)
Zimbabwe (+263)
Number
*
Enter the telephone number where you may be contacted. The telephone number is optional to complete the application.
Passport Information
Passport Number
*
Enter your passport number as it appears on your passport. The passport number may contain numbers and/or characters. Please closely distinguish between the number zero and the letter O. The passport number is required to complete the application or to check the status of your application.
Passport Issuing Country (Country of Citizenship)
*
Choose the country of citizenship, as it appears on your passport. The passport issuing country is required to complete the application.
ANDORRA (AND)
AUSTRALIA (AUS)
AUSTRIA (AUT)
BELGIUM (BEL)
BRUNEI (BRN)
CZECH REPUBLIC (CZE)
DENMARK (DNK)
ESTONIA (EST)
FINLAND (FIN)
FRANCE (FRA)
GERMANY (DEU)
GREECE (GRC)
HUNGARY (HUN)
ICELAND (ISL)
IRELAND (IRL)
ISRAEL (ISR)
ITALY (ITA)
JAPAN (JPN)
LATVIA (LVA)
LIECHTENSTEIN (LIE)
LITHUANIA (LTU)
LUXEMBOURG (LUX)
MALTA (MLT)
MONACO (MCO)
NETHERLANDS (NLD)
NEW ZEALAND (NZL)
NORWAY (NOR)
PORTUGAL (PRT)
SAN MARINO (SMR)
SINGAPORE (SGP)
SLOVAKIA (SVK)
SLOVENIA (SVN)
SOUTH KOREA (KOR)
SPAIN (ESP)
SWEDEN (SWE)
SWITZERLAND (CHE)
UK - BRITISH CITIZEN (GBR)
UK - BRITISH DTC (GBD)
UK - BRITISH NATIONAL (O) (GBN)
UK - BRITISH OVERSEAS (GBO)
UK - BRITISH SUBJECT (GBS)
UK - PROTECTED PERSON (GBP)
Passport Issuance Date
Day
*
Choose the day on which your passport was issued, as it appears on your passport under the Date of Issue field. The day on which the passport was issued is required to complete the application.
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
Month
*
Choose the month in which your passport was issued, as it appears on your passport under the Date of Issue field. The month in which the passport was issued is required to complete the application.
January
February
March
April
May
June
July
August
September
October
November
December
Year
*
Choose the year in which your passport was issued, as it appears on your passport under the Date of Issue field. The year in which the passport was issued is required to complete the application.
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
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
Passport Expiration Date
Day
*
Choose the day on which your passport expires, as it appears on your passport under the Expiration Date or Extension field. The day on which the passport expires is required to complete the application.
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
Month
*
Choose the month in which your passport expires, as it appears on your passport under the Expiration Date or Extension field. The month in which the passport expires is required to complete the application.
January
February
March
April
May
June
July
August
September
October
November
December
Year
*
Choose the year in which your passport expires, as it appears on your passport under the Expiration Date or Extension field. The year in which the passport expires is required to complete the application.
2038
2037
2036
2035
2034
2033
2032
2031
2030
2029
2028
2027
2026
2025
2024
2023
2022
2021
2020
2019
2018
Travel Information
City Where You are Boarding
Enter the last city where you will board an aircraft prior to arriving in the United States on this trip. The city where the applicant will board is optional to complete the application.
Flight or Ferry Information
Carrier Name
Choose the carrier name for the carrier on which you will be traveling to the United States, if your travel information is available. The carrier name is optional to complete the application.
3M Company
620, Inc
711 Air Corporation d/b/a 711 CODY, INC
A OK Jets
A-Jet Aviation & Aircraft Management GmbH
A. J. Walter Aviation Ltd.
A.I.R. Inc.
A/S Conair
Abbott Laboratories Inc
ABC Aerolineas, S.A. de C.V. (d/b/a Interjet)
ABS Jets A.S.
Ace Aviation Services Corporation
Ace Flight Support
ACES Airlines
ACI
ACJet
ACL
ACM Air Charter Luftfahrtgesellschaft mbH
ACM Aviation, Inc.
Acropolis Aviation
Acxiom Corporation
Advanced Air Management
Aer Lingus P.L.C.
Aer Turas Teoranta
Aero Air LLC
AERO Air, LLC
Aero California, S.A. de C. V.
Aero Coach Airlines
Aero Coach Aviation Int'l, Inc.
Aero Coach Aviation International, Inc.
Aero Continente Chile
Aero Honduras S. A. de CV
Aero Jet International
Aero Mexico
Aero Personal, S.A. de C. V.
Aero Peru
Aero Services Executive
Aero Toy Store, LLC
Aeroflot Russian International Airlines
Aerolineas Argentinas
Aerolineas Centrales de Colombia, S.A.
Aerolineas Dominicanas S.A.- Dominair
Aerolineas Ejecutivas, S.A. de C.V.
Aerolineas Nicaraguense, S.A.
Aerolineas Santo Domingo
AeroLogic GmbH
Aeromar Airlines
AEROMAR/AERO MAR
Aeromexico Airlines
Aeronautica de Cancun, S.A. de C.V.
Aeroperu
Aeroposta
Aeropostal Airlines/Linea Aeropostal Venezolana
Aeropostal Alas de Venezuela, C. A.
Aerosvit Airlines
Aerotours Dominicano Airlines/Dominair/Dominican A
Aerotransportes Corporativos S.S. de C.V.
Aerovias de Mexico, S.A. de C.V.
Aerovias Nacionales de Colombia
Aerovias Venezolanas, S.A.
AGCO, Inc.
Agent Chrysses Demitriades & Co.
Agent Transocean Tour
AIH
AIM Aviation
Air 2000 Airlines Limited
Air Afrique
Air Alsie
Air America
Air America, Inc.
Air Anguilla Inc.
Air Aruba
Air Atlanta Europe Limited
Air Atlanta Icelandic
Air Atonabee, Ltd.
Air B. C., Limited
Air B.V.I., Ltd.
Air Belgium
Air Belgium Int'l., S.A.
Air Berlin
Air Borinquen
Air Canada
Air Canada's Connector
Air Caraibes
Air Caraibes Exploitations
Air Caribbean Ltd.
Air Caribe International, Inc.
Air Center Helicopters, Inc.
Air Charter Limited
Air Charter Network, Inc.
Air Charter, Inc.
Air China
Air Club International/Lignes Aeriennes Globe Azur
Air Columbus
Air Comet
Air Culebra
Air Espana, S. A.
Air Europa
Air Europe Italy
Air Europe, Ltd.
Air Europe, S. p. A.
Air Evasion
Air Executive Charter GmbH
Air Executive LU. at GmbH
Air Florida Airlines
Air France
Air Gambia, Ltd.
Air Georgian Ltd.
Air Ghislaine, Inc
Air Greenland AS
Air Group Inc., The
Air Guadeloupe
Air Independence GmbH
Air Independence GMBH Austria
Air Independence GMBH Germany
Air India
Air Italy S.p.A.
Air Jamaica Limited
Air Japan Co., Ltd.
Air L. A., Inc.
Air Liberte, S.A.
Air Luxor
Air Malta Company Ltd.-Air Malta
Air Mango, Ltd.
Air Marshall Islands, Inc.
Air Martinique
Air Medical Ltd.
Air Micronesia, Inc.
Air National Corporate Ltd
Air Nauru
Air New Zealand Limited
Air Niagara Express, Inc.
Air Niugini
Air North Canada
Air North Charter & Training
Air Nova, Inc
Air Ontario
Air Operations of Europe AB
Air Outre Mer
Air Pacific Limited
Air Paraguay/LAPSA
Air Partner Inc.
Air Plus Comet
Air Portugal - TAP
Air Rutter International
Air Santo Domingo Alias Aereos Profesionales
Air St. Barthelemy
Air St. Martin
Air Sunshine Inc.
Air Sweden
Air Tahiti
Air Tahiti Nui
Air Taxi, Inc.
Air Toronto
Air Transat
Air Transat A.T., Inc.
Air Transport Int'l., LLC
Air Tungaru Corporation
Air Ukraine
AirBC Limited
Airborne, Inc.
Aircraft Services Group
Aires S.A.
AirFlite, Inc
Airline of the British Virgin Islands
Airmark Aviation, Inc.
Airojet Charters
Airours Int'l. Airways, Ltd.
AirSprint
Airtours International Airways, Ltd.
Airways International
Airways International, Inc.
ALADIA AIRLINES S.A. DE C.V
Alaska Airlines Inc.
ALIA-The Royal Jordanian Airlines
Alitalia
Alitalia-Linee Aeree Italiane
All Nippon Airways
Allegheny Commuter
Allegro Airlines
Alltech Inc.
ALM 1997 Airline N.V.
Aloha Airlines
Altria Corporate Services, Inc.
America West Airlines, Inc.
American Airlines, Inc.
American Eagle, Inc.
American International Airways, Inc.
American International Group
American Trans Air n/k/a ATA Airlines Inc.
Amerijet International Inc.
Ameriprise Financial, Inc
Amira Air
Amstan Air
Amy's Kitchen
ANA
ANGLO AMERICAN SOUTH AFRICA LIMITED
Antilliaannse Luchtvaart Maatschappij
AOM French Airlines
AON Corporation
APA International Air, S.A.
Apelearir
Aquilam Corporation
Arik Air Limited
Arrow Air Inc.
ASA
Aserca Airlines Venezuela
Asiana Airlines, Inc.
Astraeus Airlines Limited
Astral Aviation, Inc.
ATA Airlines, Inc. f/k/a American Trans Air, Inc.
Athabaska Airways Ltd.
ATI
Atlantic Air, BVI, Ltd
Atlantic Coast Airlines
Atlantic Coast Jet, Inc.
Atlantic Southeast Airlines
Austrian Airlines
Av Atlantic
Avcon Jet AG
Avemex, S.A. de C.V.
Avensa
Aventis Flight Operations
Aviacsa
Avianca Airlines/Pan American World Airways System
Aviateca S.A.
Aviation Concepts Inc.
Aviation Leasing, Inc.
Aviation Resource Management, INC./DBA Jet Charter,
Aviation Services, Ltd.
Avijet UK Ltd.
Avior Airlines
AVJET Corporation
Azteca
BA European Ltd. (Open Skies)
BAE Systems Inc.
Bahamas Air
Bahamasair
Bahamasair Holdings, Ltd
Balair A G
Balkan-Bulgarian Airlines
BASF Corporation
Becton Dickinson & Co
BeeWee
Belair Airlines AG
Bering Air, Inc.
Bertelsmann AG
Berwind Corporation
Biman Bangladesh Airlines
Bimini Island Air, Inc.
Bloomberg Services, L.L.C.
Blue City Holdings
Blue Line
BMA
BMW Flight Service
Bohlke International Airways, Inc.
Bombardier Aerospace Corporation
BOOKAJET
BP America, Inc.
Bradley Services Limited
Brendan
Britannia Airways A.B.
Britannia Airways GmbH
Britannia Airways, Ltd.
Britannia GmbH
British Airways
British Midland Airways Ltd.
British United Airlines Ltd./Caledonian Airways
British West Indian Airways
Brokerage & Management Corporation
Business Express Airline
Business Jet Services
BWI Int'l./Trinidad & Tobago (BWIA Int'l.) Airways
BWIA International Airways Ltd.
BWIA West Indies Airways Ltd.
CAAC
CAL
Caledonian Airways Limited
Canada 3000 Airlines, Ltd.
Canadian Airlines
Canadian Airlines International, Ltd
Canadian American Transport Systems, L.L.C.
Canadian Pacific Airlines
Canadian Partner
CanAir Cargo Ltd.
CanAir Cargo/CanAr/Nolinor
Canarsie Holdings, LLC
Caneel Bay, Inc.
CanJet
Cape Air
Cargair Ltee
Cargill Incorporated
Cargo Jet Airways
Cargolux Airlines International, S.A.
CaribAir Caribbean Atlantic Airlines, Inc./Caribbea
Caribbean Air Carrier, Inc.
Caribbean Airlines Co., Ltd.
Caribbean Sun Airlines
Caribbean Wings, Inc.
Carlisle Air Corporation
Carlson Companies
Case Corporation (now d/b/a CNH America LLC)
Cat Aviation AG
Cathay Pacific
Cayman Airways
Central Mountain Air, Ltd.
Ceridian Corporation
CFG Service Corporation
Chalk's International Airlines
Challenge Air Luftverkehrs GmbH
Chartright Air, Inc.
Chartwell Aviation Services, L.L.C.
Chautauqua Airlines, Inc.
Cherokee Air Ltd.
Chicago & Southern Air Lines, Inc./Delta-C&S Air L
China Airlines, Ltd.
China Eastern Airlines
China Southern Airlines
CitationShares Management LLC
CitationShares Management LLC
Citigroup Corporate Aviation
City Bird
City Express
City Wings, Inc.
Civil Aviation Administration of China
Clair Aero
Clay Lacy Aviation, Inc
Clint Aero
Clinton Aviation Services
CNH America LLC (formally Case Corporation)
Coastal Air Transport
Colleen Corporation-GSK Aviation
Comair
COMLUX Aviation, A.G.
COMLUX Malta LTD
Commander Mexicana, S.A. de C.V.
Compagnie des Iles du Ponant
Compagnie Francaire (Air France)
Compagnie Francaise de Croisieres
Compagnie Francaise de Transports Aeriens
Compania Mexicana de Aviacion
Compania Panamena de Aviacion, S.A.
Comtel-Air Luftverkehrs GmhB
Conair of Scandinavia
Condor
Condor Flugdienst GMBh
Conifair Aviation/Royal Airlines
ConocoPhilips - Aviation
Consorcio Aviaxsa S.A. de C.V.
Containership Agency, Inc
Continental Air Micronesia
Continental Airlines
Continental Micronesia
COPA
Corporacion Aero Angeles
Corporacion Ferries del Caribe
Corporate Air Charters
Corporate Jet Management SA
Corporate Jets XXI
Corporate Jets, LLC
Corporate Wings INC.
Corse-Air International, S.A.
Craig Evans Corporation d/b/a Flightexec
Crossair A.G.
Crow Executive Air, Inc.
CrownAir
CTA Ltd./c/o SWISSAIR
Czech Airlines
Czechoslovak Airlines/Ceskoslovenske Aerolinie
DACAR International Inc.
Daimler Chrysler Aviation GmbH d/b/a DCA GmbH
DASNAIR S.A.
Dassault Falcon Service
Daystar Airways, Ltd.
DC Aviations GmbH
Delta Air Lines
Delta Airelite Business Jets
Delta Connection
Deutsche Lufthansa Aktiengesellschaft
Deutsche Seereederie Rostock GmbH
Deutsche Seetouristik GmbH
DFS-UK, Limited
Diamond International Airlines, Inc.
Division of Soundair Corporation
Dolphin Atlantic, Inc.
Domtrave Airways
Dow Chemical Company
DR Holdings Corporation
Dupont
Dutch Caribbean Airlines
E. I. du Pont de Nemours & Co.
Eagle Aircraft & Transportation Management, Inc.
Eagle Airlines
Eastern Airlines
Eastern Metro Express
Eastman - Kodak Company
Eastman Chemical Company
Ecuatoriana de Aviacion, S.A.
EFS EUROPEAN FLIGHT SERVICE AB
Egyptair
El Al Israel Airlines Ltd.
ELANAIR, Inc.
Eli Lilly & Company
Elite Air, Inc
Emirates Airlines
Empire Airlines
Empresa Ecuatoriana de Aviacion/Ecuatoriana Airlin
Empressa de Transporte Aereo del Peru
Enterprise Rent-A-Car Company
Eolo Plus, S.A. de C.V.
EOS Airlines
Era Aviation
Ethiopian Airlines
Etihad Airways
Euro City Line
EuroAtlantic Airways
Eurofly S.p.A.
Eurofly Service, SPA
European Aviation Air Charter Ltd.
European Executive Airlines
Eva Air
EVA Airways Corporation
Everest Capital Inc.
EWA Holdings
Excalibur Airways, Ltd.
Excel Airways Limited
ExcelAire Services, Inc.
ExecuFlight, Inc.
ExecuJet
Execujet (Europe)
Execujet (Europe) GmbH
Executive Air Charter of Boca Raton
Executive Airlines, S.L.
Executive Fliteways, Inc.
Executive Jet Charter, LTD
Executive Jet Management
Express One International
Extreme Air, Inc. (aka Edwings Air Charter)
Falcon Air Express, Inc.
Faucett Airlines
Federal Mogul Corporation
Ferrymar, Inc.
Finnair
Finnair Oyj
First Air
First Choice Airways
Fitness Management Corporation
FL Aviation
Flight Ops International, Inc.
Flight Options, LLC
Flight Partners Group
Flightexec
Flugfelag Islands/Icelandic Airways/Iceland Airway
Flyglobespan
Flying Colours Airlines Ltd.
Flying Partners C.V.B.A.
Flying Services
Flyjet Limited
Formula One Management
FORTUNE BRANDS, INC
Francis & Lane Inter-Island Transport Services, Lt
Franklin/Templeton Travel, INC.
Fred. Olsen Cruise Lines Ltd.
Freedom Air
Freedom Airlines
Freeman Air Charter Services
G5 Executive AG
Gama Aviation Limited
Gama Charters
GAMA CHARTERS
Garuda Indonesia
Gavilan Corporation
General Aviation Flying Service
General Dynamics Corporation
Gestair
Ghana Airways
Gifford Laboratories, LLC
Glacier Wings Flying Services Ltd.
Glen West 300 Inc.
Global Airways
Global Aviation Services, Ltd.
Global Exec Aviation
Global Exec Aviation
Global Jet Austria GmbH
Global Jet Luxembourg S.A.
Global Mission, LLC Catalina Aerospace Corp
GlobalJet Corporation
Globe Azur Airline, Inc.
Globespan Airways Limited d/b/a Flyglobespan
Golden Airlines
Gorda Aero Services
GR 1040
Great American Airways, Inc
Great Circle
Grupo Taca
Guam Marianas Air
Gulf Air Company
Gulf Air Transport/Gulf Air
Gulfstream International Airlines
Guyana Airways Corporation
GX Aviation
H.C.L. Aviation, Inc.
Hainan Airlines, Ltd.
Haiti Trans Air
Halisa Air
Hangar 8
Hapagfly
Harbour Air Ltd.
Harlequin Air Corporation
Harrah's Entertainment Aviation
Harsco Corporation
Hawaiian Airlines
Haytian Aviation Line, SA
Heartland Aviation
Helijet Airways
HERITAGE FLIGHT (Elanair)
Hertz Corporation
HMY Airways
Honeywell International
Hop-A-Jet
Horizon Air/Horizon Air Industries, Inc./Manha
Horizon Airlines
Hotel Playaventura, S.L.
Household Aviation, LLC
HSBS Technology Services
Hughes Flying Service
Hurtigruten
Hyperion Air, Inc.
Hyundai Motor Company
I.T.T. Industries
IBC Airways
Iberia Airlines
Iberia Airlines of Spain
Iberia Lineas Aereas de Espana
IBM Flight Operations
Icarus Aviation
Iceland Express
Icelandair
Image Air Charter
Imperial Airlines, Ltd.
IMS Health Transportation Services Corporation
Independent Air
Inland Air Charters
Insel Air
Intair, Inc.
Inter Island Express
Inter-Island Boart Services
InterActiveCorp
Interface Operations LLC
Interjet
Interlaken Capital Aviation Services
International Aviation Holdings, Inc.
International Group LLC
Isla Nena Air Service
Island Airlines
Island Birds
Island Helicopters International
Island Wings Air Service
ISRAIR
Ivanho Capital Aviation
J. D. Valenciana Airline
Jackson National Life Insurance Co.
JAL
JALways Co., Ltd.
Japan Air Charter Co., Ltd.
Japan Air System Co., Ltd.
Japan Airlines Co., Ltd.
Japan Asia Airways Co. Ltd.
Japan Universal System Transport Co., Ltd.
JAT
JEGE, Inc.
JEM Investments
Jet Airways (India)
Jet Aviation Business Jets AG
Jet Aviation Business Jets AG
Jet Aviation Business Jets Deutschland GMBH
Jet Aviation Business Jets, Inc.
Jet Aviation Flight Services, Inc.
Jet Blue Airways Corporation
Jet Center, Inc.
Jet Charter Inc.
Jet Club LTD.
Jet Direct
Jet Select
Jet Team, Inc.
Jet-Link AG
Jet2.com
Jetairfly
Jetalliance Flugbetriebs AG
JetConnection Business Flight AG
JetNetherlands B.V.
Jetsgo
Jetstar Airways
Jim Pattison Industries, Ltd.
Jin Air Co, LTD.
JMC Airlines Limited
K Services
KaiserAir, Inc.
Kelowna Flightcraft Air Charter
Kenmore Air Harbor
Key Air Inc.
Key Airlines
KIWI International Air Lines, Inc.
KIWI International Holdings
KLM-Royal Dutch Airlines
Koninklijke Luchtvaart Maatschappij N.V./Northwest
Korean Air
Korean Air Lines
Kuwait Airways Corporation
L'Avion
L.J. Aviation (a/k/a L.J. Associates)
L.S.J., LLC
La Caribeenne des Transportes Aeriens
LAB Airlines
LACSA Airlines
Ladeco, Ladeco Airlines
Laker Airways
Laker Airways Incorporated
LAN Argentina
LAN Chile Airlines
LAN Dominicana
LAN Peru S.A.
LAPA
LAPSA
Las Vegas Sands Corporation
Lauda Air
Lauda Air S.p.A.
LAW Aviation
Leeward Island Air Transport Services (LIAT)
Leisure Air
Leisure International Airways Ltd.
LIAT
Liat (1974) Ltd.
Liberty Aviation Company LTD.
Lignes Aeriennes Globe Azur
Limited Brands Inc.
Linea Aerea de Navegacion Deomincana, S.A.
Linea Aerea Del Cobre, S.A.
Linea Aerea Nacional-Chile, S.A.
Lineas Aereas Allegro, S.A. de C.V.
Lineas Aereas Azteca
Lineas Aereas Costarricenses, S.A.
Lineas Aereas Paraguayas, S.A.
Lineas Aereas Privadas Argentinas S.A.
Livingston, S.p.A.
Lloyd Aereo Boliviano, S.A.
Lloyd Aero Boliviano
London Air Services
London City Airport Jet Centre
London Executive Aviation
Lone Star Airlines
LOT-Polish Airlines
LTU International Airways
LTU Lufttransport-Unternehmen GmbH & Co. KG
Lucent Aviation Division
Lufthansa German Airlines
Luxair
M & N Aviation
Magadan (Mavial) Airlines
Maine Aviation Aircraft
Majestic Jet Inc.
Malaysian Airline System Berhad
Malaysian Jet Services SDN BHD
Malev-Hungarian Airlines Public Limited
Maple Leaf Adventures
Maritime Air Charters
Martinair Holland, N.V.
Martinair, Inc.
Max Aviation, Inc.
MaxJet Airways, Inc.
McGraw-Hill Flight Department (The)
Media Consulting Services, LLC
Meridiana Fly S.p.A. (fka Eurofly S.p.A.)
Mesaba Airlines
Metropix UK LLP
Mexicana
Mexicana Airlines
Mexicana de Aviacion
MGM Grand Air
MGM Mirage Aviation
Miami Air International
Michelin North America
Midwest Airlines
Midwest Aviation
Midwest Express Airlines, Inc
Midwest Express Airlines, Inc./Midway Express Hold
Midwest Express Holdings, Inc.
MILLBURN WORLD TRAVEL SERVICES LTD
Million Air Charter Teterboro
Minerva Airlines
Minerve
Misty Fjords Air & Outfitting
Monarch Airlines Ltd.
MP Ferrymar, Inc.
N180CHG, Inc.
N252CH, LLC
N540CH, LLC
Nashville Eagle
Nashville Jet Charters Inc.
Nationair Canada
National Air Charters, Inc.
National Express Company
Native Son, Inc.
Nautilus Explorer
NEOS S.p.A
NetJets
Netjets Transportes Aereos
Nevis Express Ltd.
New World Jet Corporation
New York Central Railroad
News America Inc.
NICA/Aeronica
Nigeria Airways Ltd.
Nippon Cargo Airlines Co., Ltd.
Nishinihon Kisen Co., Ltd.
Nissan North America
Nolisair International Inc.
Norman Aircraft Leasing
North American Air Charter
North American Airlines
Northern Jet Management
Northwest Airlines
Northwest Airlink
Northwest International Airways, Ltd.
Northwest Orient Airlines
Novair International Airways
NSB
NSB Niederelbe Schiffahrt Gesellschraft MBH & Co.
Oak Bay Beach Hotel & Marine Resort
Oasis International Airlines
Ocean Quest International
Ocean Sky (UK) Limited
Ocean Wings Air Charters
Odyssey Aviation Limited
Olympic Airways, S.A.
Omni Air International
Ontario Express
Open Skies
Open Skies
Orion Air
Orion Lift Service, Inc.
Other
Owens Illinois General
Pace Airlines
Pacific Island Aviation
Pacific Stream Company (PTC) LTD
Pakistan International Airlines
Palau Micronesia Air
Pan Am Express
Paradise Island Airlines
Paramount Pictures / Viacom
Partner Jet Incorporated
PAWA Dominica (Pan Am World Airways Dominicana)
Pegasus Elite Aviation, Inc.
Penn Central Company (The)
PepsiCo Inc.
Personal Jet Charters
Peter Island Resort & Yacht Harbor
Pfizer, Inc.
Philip Morris Management Corporation
Philippine Airlines
Phoenix Air
Phoenix Air Group, Inc.
Piedmont Airlines
Piedmont Hawthorne Aviation Charter Division
Plan Aeronaves
Planet Airways
PMI GLOBAL SERVICES, INC
Points of Call Airlines, Ltd.
Polar Airlines de Mexico S.A. de C.V.
Polaris Aviation Solutions LLC
Polynesian Airlines (Holdings) Limited
Ponant, Compagnie des Isles du
Porter Airlines Inc.
PPG Industries
Premiair A/S
Premier Air
Premier Aviation, Inc.
Premium Jet AG
Priester Aviation
Primaris Airlines
Prime Jet LLC
PrivatAir GmbH
PrivatAir GmbH/PrivatAir S.A.
PrivatAir S.A.
Private Jet Charters, LLC
ProJet Aviation
Promech Air, Inc.
Promech, Inc.
Propinvest Asset Management LLP
PROSPECT AVIATION CORPORATION
Provincial Airlines Ltd.
Pullmantur Air
Qantas Airways, Ltd.
Qantas Empire Airways, Ltd./British Commonwealth P
Qatar Airways
Quassar de Mexico, S.A.
R.O.P. Aviation, Inc.
Rainbow International Airlines
Raven Aviation LLC
Red Lion Charter/Spirit of America/
Reeve Aleutian Airways
Regional Air Charters, Inc.
Reno Air
Resa Aviation
ResidenSea
Rich International Airways, Inc.
Richmor Aviation, Inc.
Rifton Aviation Services
RONSO, S.A. de C.V.
Royal Air Maroc
Royal Aviation, Inc.
Royal Jordanian
Ryan International Airlines
S Seabourn Cruise Line
SAA
Sabena Belgian World Airlines
Sabena, S.A.
SAETA S.A./Saeta Airlines
Samsung Techwin
San Juan Aviation
San Juan Jet Charters, Inc.
Santa Barbara Airlines
SAS
SAS Institute
SATA Internacional
Saudi Arabian Airlines
Scanair
Scandinavian Airlines System
Scotts Company, The
Seaborne Airlines
Seaborne Aviation, Inc.
SeaFlight Aviation Limited
Sentient Flight Group LLC
Servair
Service et Transports Cruise Lines, S.A. (STCLS)
Servicios Aereos Litoral, S.A. de C.V.
Servicios Aereos Profesionales
Servicios Aeronauticos Aeropersonal, S.A. de C.V.
Servicios Avensa, S.A.
Servicos E Transportes Aereos, S.A.
Servivensa
Servizi Aerei S.P.A.
Sierra Pacific Airlines
Silverjet
Silverjet Air Operations Limited
Singapore Airlines
Sirio S.P.A
SK Travel, LLC.
Sky King
Sky Trek International Airlines, Inc.
Skybird Aviation, Inc.
Skylink Jets, Inc.
Skyservice Business Aviation Inc
Skyservice Business Aviation LLC
Skyservice F.B.O., Inc.
SkyTrek
SkyWest Airlines
SkyXpress Airlines
Snowbird Aviation
Sobelair N.V./S.A.
Sociedad Ecuatoriana de Transportes Aereos Ltd.
Societe Caribbeenne de Transport Aerien
Societe Nouvelle Air Guadeloupe
Societe Nouvelle Air Martinique
Sol Air
Solid Air
SONY Europe GmhB
South African Airways
Southeast Airlines
Spanair, S.A.
Spirit Airlines
ST Aviation, LLC
St. Croix Air Link
Stanford Financial Group Co.
Star Clippers, Inc.
Starair Ltd.
Starbucks Corporation
Starjet Airways
Starlink Aviation
STCL-Services et Transports Cruise Lines, S.A
Sterling Airways
Sterling European Airlines A/S
Suckling Airways
Summit Air Charters
Summit Air Charters Ltd.
Sun Air Jets, LLC
Sun Country Airlines
Sunair Express
Sunset Aviation LLC
Sunwest Aviation Ltd.
Sunwing Airlines
Sunworld Airlines
Sunworld International Airlines, Inc.
Surinam Airways Ltd.
Swiss
Swiss Air Transport Co. Ltd.
Swiss International Airlines
Swiss Jet
Swiss World Airways, S.A.
Swissair
Synthes USA LP
TACA
Taca International Airlines, S.A.
TACV-Cabo Verde Airlines
TAESA Airlines
TAG Aviation Espana
Tag Aviation SA, Inc
Tag Aviation UK
Talon Air
TAM Airlines
Tampa Airlines
TAN (Transportes Aereos Nacionales, S.A.)
Tan Airlines or Tan Sahsa
TAP - Air Portugal
Taquan Air Service Inc.
TAROM - Romanian Air Transport
Tasair Aviation, S.A.
Taughannock Aviation Corporation
Tavaero Jet Charter
TEA France
TEM Enterprises
Tempus Jets, Inc.
Thai Airways International, Ltd.
The Air Group
The Delta Connection
The Drax Group, Inc.
The Scotts Company
The Whitewind Co.
The Whitewind Company
Thomas Cook Airlines Ltd.
Thomas Cook Airlines Ltd. Scandinavia A/S
Thomas Cook Airlines Ltd. Scandinavia A/S
Thomson Airways Limited
Threshold Air Charter Inc.
Threshold Technologies
ThyssenKrupp Diensteistungen GmbH
Time Air Sweden AB
Titan Airways
Tower Air, Inc.
Tower Airlines, Inc.
Townsend Engineering Company
Tradewinds Airlines
Tradewinds Aviation
Trans Continental Airlines
Trans European Airways France
Trans International Airlines
Trans Meridian Airlines
Trans World Airlines, Inc.
Trans-Caribbean Air Export-Import
Trans-Exec Air Service
Trans-Provincial Airlines Ltd.
TransAero Airlines
Transavia Airlines C.V.
Transbrasil Airlines, Inc.
Transbrasil S/A Linhas Aereas
Translift Airways Ltd.
TransMeridian Airlines
TransMeridian Aviation, LLC
TransOcean Airways
Transporte Aereo Dominicano, S.A.
Transporte Aereo NAO Regular, S.A.
Transporte Aereo Tecnico Ejecutivo (TATESA)
Transportes Aereos Ejecutivos
Transportes Aereos Excel, S.A. de C.V.
Transportes Aereos Mercantiles Panamericanos
Transportes Aereos Mercantiles Panamericanos, S.A.
Transportes Aereos Meridionaise
Transportes Aereos Mexiquenses
Transportes Aereos Nacionales, S.A.
Transportes Aereos Portugueses S.A.R.L. (TAP)
Transportes Aeromar, S.A. de C.V.
Transwede Leisure AB
Travel Service A.S.
Triair Bermuda, Ltd.
Triangle Aircraft Services Corporation
Triple Alpha Luftfahrtgesellschaft GmbH
Tropic Air Charters
Tropical Aviation Corp.
Trump Shuttle, Inc.
Tudor Investment Corporation
TUI Airlines Belgium N.V
TUIfly Nordic A.B.
Turk Hava Yollari A.O.
Turkish Airlines
Turks and Caicos Airways, Ltd
Turquoise Airways Ltd.
TWA
TWA Airlines LLC
TWC Aviation
Twin Air
Twin Town Leasing Co
Twinjet Aircraft Sales Limited
Tyrolean Jet Service Nfg. GmbH & Company KG
U.S. Air, Inc.
U.S. Aviation
Ukrainian State Airline
Unijet
United Airlines
United Parcel Service Co.
United States Aviation, Co.
United States Steel Corporation
Universal Air Services Limited
Universal Airlines
Universal Jet Aviations
UPS
US Airways
USA 3000 Airlines
USAfrica Airways
USAir Express
USAir Express/US Air
Uzbekistan Airways
V Australia
V. Kelner Pilatus Center
Vacationair Inc.
Varig
VASP Brazilian Air Lines
Venezolana Internacional de Aviacion, S.A
VG Airlines
Viacao Aerea Rio-Grandense/Varig Airlines
Viacao Aerea Sao Paulo, S.A. (VASP)
VIASA
Viking International Airlines
Virgin Air Inc.
Virgin America
Virgin Atlantic Airways Ltd.
Virgin Gorda, Transport Ltd.
Viscount Air Service
VistaJet Luftfahrtunternehmen GmbH d/b/a VistaJet
Viva Aero Bus
Vivendi Universal
Vladivostok Air
VOLARIS
Volkswagen AG Air Service
Volo Aviation LLC
VstaJet
WAC
Waglisla Air Inc.
Wal-Mart Stores, Inc.
Walker's Aviation Services, Inc.
Walker's International
Watemakers Air
Wayfarer Aviation
West Jet Airlines Limited
West Travel Inc.
Westair Aviation Ltd.
Western Air Charter
Western Air Services
WestJet Airlines Ltd.
White Airways S.A.
White Cloud Charter, Inc.
Win Air
Windsor Jet Management
Windward Island Airways
Windward Island Airways International N.V.
Wirtgen Beteiligungsgesellschaft GmbH
WISC Ltd.
World Air Network Co., Ltd.
World Airways, Inc.
Worldways Canada Ltd.
Worldwide Airline Services, Inc.
Worldwide Jet Charter, L.L.C.
Wotan America, Inc.
WRA
WRA/Caribbean
Xerox Corporation
XL Airways France
Xtra Airways
Y Guahan Airways, Inc.
Yucaipa Companies
Yugoslav Airlines
Yum! Brands, Inc.
Zeeco, Inc.
Ziff Brothers Investments
Zimmer Inc.
Zip Air Inc.
Zoom Airlines, Inc.
Zuliana de Aviacion C.A.
Admiral Cruise Lines
Admiral Cruises, Inc
Agent Ulysses Cruises, Inc.
AIDA Cruises
American Viking Cruise Line
American Viking Lines Limited Company
Atlantic Container Line
B. S. L. Cruises, Inc.
Bay Ferries Limited
Bermuda Star Line
Black Sea Shipping Co.
Blackbeard's Cruises
Bluewater Adventures Ltd
Canberra Cruises
Cape Canaveral Cruise Line
Caribbean Maritime Excursion
Carnival Cruise Lines, Inc
Celebrity Cruises
Chandris Fantasy Cruises
Chandris, Inc.
Clipper
Clipper Adventure Cruises
Clipper Cruise Line
Club Cruise, B.V.
Commodore Cruise Line
Commodore Cruise Line, Ltd.
Cool Tours, Inc.
Costa Crociere S.P.A.
Costa Cruises, Inc
Crown Cruise Line
Cruise West
Crystal Cruises, Inc.
CTC Cruise Lines
Cunard Line Limited
Delta Queen Coastal Voyages, L.L.C.
Delta Queen Steamboat Company
Discovery Cruise Line, Inc
Discovery Cruises Limited
Discovery World Cruises
Disney
Disney Cruise Line
Dolphin Cruise Lines
Dolphin Maritime Ltd.
DSR Lines
Epirotiki Lines, Inc.
Festival Cruises, Inc.
Festival Shipping & Tourist Enterprises
Frontier Cruises Ltd.
Great Lakes Cruises, Inc
Hanseatic Cruises
Hapag-Lloyd A.G./North German Lloyd Passenger
Hapag-Lloyd Cruises
Hapag-Lloyd Kreuzfahrten GmbH
Happy Days Shipping Limited
Holland America Line Westours
Institute for Shipboard Education
International Maritime Resources
International Shipping Partners (Pearl Owner Ltd.)
Ivaran Lines
Japan Cruise Line
Kloster Cruise Limited
Kloster Cruise Limited (See Norwegian Cruise Line)
Lady Lou Shipping Co., Ltd.
Lindblad Maritime Enterprises
Louis Cruise Lines
Luxembourg Shipping Services
Magical Cruise Company, Limited
Majesty Cruise Lines
Mar Line Universal Shipping Co
Maxim Gorkiy Shipping Co., Ltd.
Mediterranean Transportation Inc.
Mitsui O.S.K. Lines, (Passenger) Ltd.
MS Berlin
MS Deutschland
MSC Mediterranean Shipping Co., S.A.
New World Ship Management Company, LLC
Nippon Yusen Kaisha (NYK)/Crystal Cruises/NYK Line
Norwegian Cruise Lines
NYK Cruises Co., Ltd.
Odessa America Cruise
Odessa America Cruise Co
Odessa Cruise German Shipmanagement
Orient Lines Ltd.
P & O Cruises
Party Line Cruise Company
Passat Ship Management Company Ltd.
Pearl Owner Ltd. (International Shipping Partners)
Phoenix-Reisen a/k/a V-Ships Leisure S.A.M.
Poetto Shipping Co., Ltd.
Premier Cruise Lines
Prince of Fundy Cruises Limited
Princess Cruises
Radisson Seven Seas Cruises
Red Star Line/Holland-America Line
Regency Cruises, Inc.
Renaissance Cruises, Inc.
Rochester Ferry Company, LLC.
Royal Caribbean Cruise Line
Royal Olympic Cruises Ltd.
Royal Viking Line
Saga Shipping Company, Ltd.
Schiffahrtsgellschaft MS Berlin Kreuzfahrten mbH &
Schiffahrtsgesellschaft MS Deutschland GMBH & Co.
Schiffahrtsgesellschat MS Berlin GmbH & Co.
Scotia Prince Cruises Limited
Sea Delphin Shipping, Ltd.
Seabourn Cruise Line
SeaDream Yacht Club
SeaEscape, Ltd.
Seetours
Seven Seas Cruise Line Ltd.
Showa Line, Ltd.
Silversea Cruises
Smith's Ferry Services, Ltd.
Society Expeditions, Inc.
Society Expeditions, Inc.
St. Lawrence Cruise Lines Inc.
Tall Ship Adventures, Inc.
The China Navigation Co., Ltd.
The Cunard Steam-Ship Co., Ltd.
Topaz International Shipping, Inc.
Ulysses Cruises Inc.
V-Ships Leisure S.A.M. d/b/a Phoenix-Reisen
Vistamar Canarias, S.L.
Vistamar Cruise Line
Windstar Sail Cruises
World Explorer Cruises
World of ResidenSea Ltd., The
Flight Number or Ferry Name
Enter the flight number or vessel name for the carrier on which you will be traveling to the United States, if your travel information is available. The flight number or vessel name is optional to complete the application.
Address While In The United States
Address Line 1
Enter the number and street of the location where you will stay while in the United States. Do not include the city and state in this field. The address 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. You may update this information once confirmed. • If you are leaving the United States immediately and do not have an address, enter the words ”In Transit” and your final destination location.
Address Line 2
Enter apartment, suite, unit, floor, building, or other, if appropriate. Do not include the city and state in this field. Address line 2 is optional to complete the application.
City
Enter the city of the address where you will stay while in the United States. The city is optional to complete the application.
State
Enter the state of the address where you will stay while in the United States. The state is optional to complete the application.
ALABAMA
ALASKA
AMERICAN SAMOA
ARIZONA
ARKANSAS
CALIFORNIA
CANTON & ENDERBURY ISL
COLORADO
CONNECTICUT
DELAWARE
DISTRICT OF COLUMBIA
FLORIDA
GEORGIA
GUAM
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
NORTH MARIANA ISL
OHIO
OKLAHOMA
OREGON
PENNSYLVANIA
PUERTO RICO
RHODE ISLAND
SOUTH CAROLINA
SOUTH DAKOTA
TENNESSEE
TEXAS
UTAH
VERMONT
VIRGIN ISLANDS
VIRGINIA
WASHINGTON
WEST VIRGINIA
WISCONSIN
WYOMING
Emergency Contact Information In or Out of the United States
Family Name
*
Enter your emergency point of contact who may be a person in or outside of the United States, e.g., a family member, friend, or business associate. In the Family Name field, enter your emergency contact’s family name. You must complete this field to complete the application. If you have no emergency contact, enter UNKNOWN.
First (Given) Name
*
Enter your emergency point of contact who may be a person in or outside of the United States, e.g., a family member, friend, or business associate. In the First (Given) Name field, enter the emergency contact’s first name. You must complete this field to complete the application. If you have no emergency contact (or your contact has only one name), enter UNKNOWN.
E-Mail Address
*
Enter your emergency contact's e-mail address. E-mail address is required to complete the application. You may also enter UNKNOWN.
Telephone Number
Country Code
*
In the Country Code field, enter the country code of your emergency contact's telephone number. The country code is required to complete the application. If you do not have an emergency contact telephone country code you may enter zeros.
Afghanistan (+93)
Albania (+355)
Algeria (+213)
American Samoa (+1684)
Andorra (+376)
Angola (+244)
Anguilla (+1264)
Norfolk Island (+672)
Barbuda (+1268)
Argentina (+54)
Armenia (+374)
Aruba (+297)
Ascension (+247)
Australia (+61)
Austria (+43)
Azerbaijan (+994)
Bahamas (+1242)
Bahrain (+973)
Bangladesh (+880)
Barbados (+1246)
Belarus (+375)
Belgium (+32)
Belize (+501)
Benin (+229)
Bermuda (+1441)
Bhutan (+975)
Bolivia (+591)
Bosnia & Herzegovina (+387)
Botswana (+267)
Brazil (+55)
Brunei Darussalam (+673)
Bulgaria (+359)
Burkina Faso (+226)
Burundi (+257)
C?d'Ivoire (+225)
Cambodia (+855)
Cameroon (+237)
United States of America (+1)
Cape Verde Islands (+238)
Cayman Islands (+1345)
Central African Republic (+236)
Chad (+235)
New Zealand (+64)
Easter Island (+56)
China (PRC) (+86)
Cuba (+53)
Colombia (+57)
Mayotte Island (+269)
Congo (+242)
Congo, Dem. Rep. of (former Zaire) (+243)
Cook Islands (+682)
Costa Rica (+506)
Croatia (+385)
Netherlands Antilles (+599)
Cyprus (+357)
Czech Republic (+420)
Denmark (+45)
Diego Garcia (+246)
Djibouti (+253)
Dominica (+1767)
Dominican Republic (+1809)
Dominican Republic (+1829)
Northern Marianas Islands (+670)
Ecuador (+593)
Egypt (+20)
El Salvador (+503)
Equatorial Guinea (+240)
Eritrea (+291)
Estonia (+372)
Ethiopia (+251)
Falkland Islands (Malvinas) (+500)
Faroe Islands (+298)
Fiji Islands (+679)
Finland (+358)
France (+33)
Martinique (+596)
French Guiana (+594)
French Polynesia (+689)
Gabonese Republic (+241)
Gambia (+220)
Georgia (+995)
Germany (+49)
Ghana (+233)
Gibraltar (+350)
Greece (+30)
Greenland (+299)
Grenada (+1473)
Guadeloupe (+590)
Guam (+1671)
Guatemala (+502)
Guinea (+224)
Guinea-Bissau (+245)
Guyana (+592)
Haiti (+509)
Honduras (+504)
Hong Kong (+852)
Hungary (+36)
Iceland (+354)
India (+91)
Indonesia (+62)
Iran (+98)
Iraq (+964)
Ireland (+353)
Israel (+972)
Italy (+39)
Jamaica (+1876)
Japan (+81)
Jordan (+962)
Russia (+7)
Kenya (+254)
Kiribati (+686)
Korea (North) (+850)
Korea (South) (+82)
Kuwait (+965)
Kyrgyz Republic (+996)
Laos (+856)
Latvia (+371)
Lebanon (+961)
Lesotho (+266)
Liberia (+231)
Libya (+218)
Liechtenstein (+423)
Lithuania (+370)
Luxembourg (+352)
Macao (+853)
Macedonia (Former Yugoslav Rep. of) (+389)
Madagascar (+261)
Malawi (+265)
Malaysia (+60)
Maldives (+960)
Mali Republic (+223)
Malta (+356)
Marshall Islands (+692)
Mauritania (+222)
Mauritius (+230)
Mexico (+52)
Micronesia (Federal States of) (+691)
Midway Island (+1808)
Moldova (+373)
Monaco (+377)
Mongolia (+976)
Montenegro (+382)
Montserrat (+1664)
Morocco (+212)
Mozambique (+258)
Myanmar (+95)
Namibia (+264)
Nauru (+674)
Nepal (+977)
Netherlands (+31)
St. Kitts (+1869)
New Caledonia (+687)
Nicaragua (+505)
Niger (+227)
Nigeria (+234)
Niue (+683)
Norway (+47)
Oman (+968)
Pakistan (+92)
Palestinian Settlements (+970)
Panama (+507)
Papua New Guinea (+675)
Paraguay (+595)
Peru (+51)
Philippines (+63)
Poland (+48)
Portugal (+351)
Puerto Rico (+1787)
Puerto Rico (+1939)
Qatar (+974)
R?ion (+262)
Romania (+40)
Rwandese Republic (+250)
S?Tom?amp; Pr?ipe (+239)
Samoa (+685)
San Marino (+378)
Saudi Arabia (+966)
Senegal (+221)
Yugoslavia (+381)
Seychelles Republic (+248)
Sierra Leone (+232)
Singapore (+65)
Slovak Republic (+421)
Slovenia (+386)
Solomon Islands (+677)
Somali Democratic Republic (+252)
South Africa (+27)
Spain (+34)
Sri Lanka (+94)
St. Helena (+290)
St. Lucia (+1758)
St. Pierre & Miquelon (+508)
St. Vincent & Grenadines (+784)
Sudan (+249)
Suriname (+597)
Swaziland (+268)
Sweden (+46)
Switzerland (+41)
Syria (+963)
Taiwan (+886)
Tajikistan (+992)
Zanzibar (+255)
Thailand (+66)
Togolese Republic (+228)
Tokelau (+690)
Tonga Islands (+676)
Trinidad & Tobago (+1868)
Tunisia (+216)
Turkey (+90)
Turkmenistan (+993)
Turks & Caicos Islands (+1649)
Tuvalu (+688)
Uganda (+256)
Ukraine (+380)
United Arab Emirates (+971)
United Kingdom (+44)
Uruguay (+598)
Uzbekistan (+998)
Vanuatu (+678)
Vatican City (+379)
Venezuela (+58)
Vietnam (+84)
Virgin Islands - British (+1284)
Virgin Islands - US (+1340)
Wake Island (+808)
Wallis & Futuna (+681)
Yemen (North) (+969)
Yemen (South) (+967)
Zambia (+260)
Zimbabwe (+263)
Number
*
In the Number field, enter your emergency contact's telephone number. The number is required to complete the application. If you do not have an emergency contact telephone number you may enter zeros.
Travel Information
Is your travel to the US occurring in transit to another country?
*
Indicate whether your travel to the US is occurring in transit to another country by selecting yes or no. Answering this question is required to complete your application.
Yes
No
US Point of Contact Information
US Point of Contact
*
A U.S. point of contact may be a friend, relative, or business associate. If you do not have a U.S. point of contact, please enter the name, address and telephone number of the location where you will be staying (e.g. a hotel name). You may also enter UNKNOWN.
Address line 1
*
Address Line 2
City
*
Telephone Number
*
Employment Information
Do you have a current or previous employer?
*
Indicate whether you have a current or previous employer by selecting yes or no. Answering this question is required to complete your application.
Yes
No
Employer Name
*
Enter the name of your current employer. If you are not currently employed, enter the name of your previous employer. Employer name is required to complete the application. You may also enter SELF-EMPLOYED, STUDENT, CHILD, HOMEMAKER, STAY-AT-HOME PARENT, or any other word to describe your employment status.
Job Title
Enter the job title of your current or previous employment. Job title is optional to complete this application.
Telephone Number
Address
Address line 1
*
Address Line 2
City
*
Country
*
AFGHANISTAN (AFG)
ALBANIA (ALB)
ALGERIA (DZA)
AMERICAN SAMOA (ASM)
ANDORRA (AND)
ANGOLA (AGO)
ANGUILLA (AIA)
ANTARCTICA (ATA)
ANTIGUA AND BARBUDA (ATG)
ARGENTINA (ARG)
ARMENIA (ARM)
ARUBA (ABW)
AUSTRALIA (AUS)
AUSTRIA (AUT)
AZERBAIJAN (AZE)
BAHAMAS (BHS)
BAHRAIN (BHR)
BANGLADESH (BGD)
BARBADOS (BRB)
BELARUS (BLR)
BELGIUM (BEL)
BELIZE (BLZ)
BENIN (BEN)
BERMUDA (BMU)
BHUTAN (BTN)
BOLIVIA (BOL)
BOSNIA AND HERZEGOVINA (BIH)
BOTSWANA (BWA)
BOUVET ISLAND (BVT)
BRAZIL (BRA)
BRITISH INDIAN OCEAN TERRITORY (IOT)
BRUNEI (BRN)
BULGARIA (BGR)
BURKINA FASO (BFA)
BURMA (BUR)
BURUNDI (BDI)
CAMBODIA (KHM)
CAMEROON (CMR)
CANADA (CAN)
CANTON AND ENDERBURY ISLANDS (CTE)
CAPE VERDE (CPV)
CAYMAN ISLANDS (CYM)
CENTRAL AFRICAN REPUBLIC (CAF)
CHAD (TCD)
CHILE (CHL)
CHINA (CHN)
CHRISTMAS ISLAND (CXR)
COCOS (KEELING) ISLANDS (CCK)
COLOMBIA (COL)
COMOROS (COM)
CONGO (COG)
COOK ISLANDS (COK)
COSTA RICA (CRI)
COTE D'IVOIRE (CIV)
CROATIA (HRV)
CUBA (CUB)
CYPRUS (CYP)
CZECH REPUBLIC (CZE)
DEMOCRATIC YEMEN (YMD)
DENMARK (DNK)
DJIBOUTI (DJI)
DOMINICA (DMA)
DOMINICAN REPUBLIC (DOM)
DRONNING MAUD LAND (DML)
EAST TIMOR (TMP)
ECUADOR (ECU)
EGYPT (EGY)
EL SALVADOR (SLV)
EQUATORIAL GUINEA (GNQ)
ERITREA (ERI)
ESTONIA (EST)
ETHIOPIA (ETH)
FALKLAND ISLANDS (FLK)
FAROE ISLANDS (FRO)
FIJI (FJI)
FINLAND (FIN)
FRANCE (FRA)
FRANCE METROPOLITAN (FXX)
FRENCH GUIANA (GUF)
FRENCH POLYNESIA (PYF)
FRENCH SOUTHERN TERRITORIES (ATF)
GABON (GAB)
GAMBIA (GMB)
GEORGIA (GEO)
GERMANY (DEU)
GHANA (GHA)
GIBRALTAR (GIB)
GREECE (GRC)
GREENLAND (GRL)
GRENADA (GRD)
GUADELOUPE (GLP)
GUAM (GUM)
GUATEMALA (GTM)
GUINEA (GIN)
GUINEA-BISSAU (GNB)
GUYANA (GUY)
HAITI (HTI)
HEARD AND MC DONALD ISLANDS (HMD)
HONDURAS (HND)
HONG KONG (HKG)
HUNGARY (HUN)
ICELAND (ISL)
INDIA (IND)
INDONESIA (IDN)
IRAN (IRN)
IRAQ (IRQ)
IRELAND (IRL)
ISRAEL (ISR)
ITALY (ITA)
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Do any of the following apply to you? (Answer Yes or No)
A) Do you have a communicable disease; physical or mental disorder; or are you a drug abuser or addict?
*
Communicable Diseases
Under United States law communicable diseases of public health significance include:
- Chancroid
- Gonorrhea
- Granuloma inguinale
- Leprosy, infectious
- Lymphogranuloma venereum
- Syphilis, infectious stage
- Tuberculosis, active
- And others as determined by the Department of Health and Human Services.
Physical or Mental Disorders
With regard to physical or mental disorders, answer ”Yes” to this question if:
(a) You currently have a physical or mental disorder and a history of behavior associated with the disorder that may pose or has posed a threat to your property, safety or welfare or that of others; or
(b) You had a physical or mental disorder and a history of behavior associated with the disorder that has posed a threat to your property, safety or welfare or that of others and the behavior is likely to recur or lead to other harmful behavior.
Answer ”No” if:
(a) You currently have no physical or mental disorders; or
(b) You have or had a physical or mental disorder without associated behavior that may pose or has posed a threat to your property, safety or welfare of that of others; or
(c) You currently have a physical or mental disorder with associated behavior, but that behavior has not posed, does not currently pose nor will pose a threat to your property, safety or welfare or that of others; or
(d) You had a physical or mental disorder with associated behavior that posed a threat to your property, safety or welfare or that of others, but that behavior is unlikely to recur.
Drug Abusers and Drug Addicts
Under United States law persons may not be admissible if they have been determined to be a drug abuser or drug addict.
For further information refer to § 212(a)(1)(A) of the Immigration and Nationality Act, 8 U.S.C. § 1182(a)(1)(A), and corresponding regulations in the Code of Federal Regulations.
Yes
No
B) Have you ever been arrested or convicted for an offense or crime involving moral turpitude or a violation related to a controlled substance; or have been arrested or convicted for two or more offenses for which the aggregate sentence to confinement was five years or more; or have been a controlled substance trafficker; or are you seeking entry to engage in criminal or immoral activities?
*
Crimes involving moral turpitude - Such offenses generally involve conduct which is inherently base, vile, or depraved and contrary to the accepted rules of morality and the duties owed to persons or society in general. There are factors, such as the age of the offender or the date of the offense, that may affect whether an offense will be considered a crime involving moral turpitude for purposes of the Immigration and Nationality Act.
For further information refer to § 212(a)(2) of the Immigration and Nationality Act, 8 U.S.C. § 1182(a)(2), § 101(a)(43) of the Immigration and Nationality Act, 8 U.S.C. § 1101(a)(43) and corresponding regulations in the Code of Federal Regulations.
Yes
No
C) Have you ever been or are you now involved in espionage or sabotage; or in terrorist activities; or genocide; or between 1933 and 1945 were you involved, in any way, in persecutions associated with Nazi Germany or its allies?
*
Yes
No
D) Are you seeking to work in the U.S.; or have you ever been excluded and deported; or been previously removed from the United States or procured or attempted to procure a visa or entry into the U.S. by fraud or misrepresentation? *
*
Individuals entering the United States under the Visa Waiver Program are admitted as nonimmigrant alien visitors and may not seek employment in the United States. While Visa Waiver Program travelers may not seek employment in the United States, there are many classifications of non-immigrant and immigrant employment-sponsored visas for those who qualify.
For further information refer to § 212(a)(5) of the Immigration and Nationality Act, 8 U.S.C. § 1182(a)(5).
For further information on non-immigrant and immigrant employment visas, refer to
www.travel.state.gov
.
Yes
No
E) Have you ever detained, retained or withheld custody of a child from a U.S. citizen granted custody of the child?
*
Any alien who, after entry of an order by a court in the United States granting custody to a person of a United States citizen child who detains or retains the child, or withholds custody of the child, outside the United States from the person granted custody by that order, is inadmissible until the child is surrendered to the person granted custody by that order.
For further information refer to § 212(a)(10)(C) of the Immigration and Nationality Act, 8 U.S.C. § 1182(a)(10)(C).
Yes
No
F) Have you ever been denied a U.S. visa or entry into the U.S. or had a U.S. visa canceled?
*
Yes
No
If yes: when
where
G) Have you ever asserted immunity from prosecution?
*
With regard to immunity from prosecution, answer ”Yes” to this question if all of the following apply:
(a) you have committed a serious criminal offense in the United States as defined in 8 U.S.C. Sec. 1101(h), including any felony, at any time for which immunity from criminal jurisdiction was exercised; and
(b) as a consequence of the offense and exercise of immunity identified in (a), you have departed from the United States; and
(c) you have not subsequently submitted fully to the jurisdiction of the court in the United States having jurisdiction with respect to that offense.
For further information refer to §212(a)(2)(E) and 101(h) of the Immigration and Nationality Act, 8 U.S.C. § 1182(a)(2)(E) and 1101(h).
Yes
No
Waiver of Rights:
I have read and understand that I hereby waive for the duration of my travel authorization obtained via ESTA any rights to review or appeal of a U.S. Customs and Border Protection Officer's determination as to my admissibility, or to contest, other than on the basis of an application for asylum, any removal action arising from an application for admission under the Visa Waiver Program.
In addition to the above waiver, as a condition of each admission into the United States under the Visa Waiver Program, I agree that the submission of biometric identifiers (including fingerprints and photographs) during processing upon arrival in the United States shall reaffirm my waiver of any rights to review or appeal of a U.S. Customs and Border Protection Officer's determination as to my admissibility, or to contest, other than on the basis of an application for asylum, any removal action arising from an application for admission under the Visa Waiver Program.
*
Certification:
I, the applicant, hereby certify that I have read, or have had read to me, all the questions and statements on this application and understand all the questions and statements on this application. The answers and information furnished in this application are true and correct to the best of my knowledge and belief.
For third-parties submitting the application on behalf of the applicant, I hereby certify that I have read to the individual whose name appears on this application (applicant) all the questions and statements on this application. I further certify that the applicant certifies that he or she has read, or has had read to him or her, all the questions and statements on this application, understands all the questions and statements on this application, and waives any rights to review or appeal of a U.S. Customs and Border Protection Officer's determination as to his or her admissibility, or to contest, other than on the basis of an application for asylum, any removal action arising from an application for admission under the Visa Waiver Program.
The answers and information furnished in this application are true and correct to the best of the applicant's knowledge and belief.
*
I accept the terms and conditions and have been informed that the site www.electronicesta.com is not affiliated with the U.S. government authorities or government website
cbp.gov
. The price is 59euros and covers the cost of protection of U.S. borders 14USD. I can get this form to 14USD on the official website of the U.S. Embassy, but in this case I can not benefit from your help and support.
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