Step 1 of 8 - Information 12% PLEASE READ BEFORE STARTING Only DV2025 winners and those who want to receive counseling from us should fill in our DS260 form. Our consultation fee for the whole process is $500 per person (we do not charge for children, if any). Our counseling includes filling out forms, medical check-ups, preparation of documents, pre- and post-interview procedures. You must fill in the form for yourself and, if applicable, also for your spouse and children. After filling out our form, you should make an appointment on our related page. Please fill out the form using English characters and in CAPITAL letters (do not use the letters Ç, Ğ, İ, Ö, Ö, Ş, Ü) Personal Information 1Personal Information 1CONFIRMATION NUMBER*Confirmation NumberClick for sample confirmation number SERIES NUMBER*Case NumberClick for sample case number LAST/FAMILY NAME* Surnames FIRST NAME*Given Names YOUR FULL NAME IN YOUR OWN ALPHABET*Full Name in Native Alphabet DID YOU USE ANOTHER NAME OR SURNAME?*Have you ever used other names (i.e., maiden, religious, professional, alias, etc.)? YES NO PREVIOUSLY USED SURNAME*Other Surnames Used PREVIOUSLY USED NAME*Other Given Names Used YOUR GENDER*Sex MALE FEMALE MARITAL STATUS*Current Marital StatusSelectMARRIEDSINGLEDULDIVORCEDDATE OF BIRTH*Date of BirthDay12345678910111213141516171819202122232425262728293031Month123456789101112Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920YOUR AGEPLACE OF BIRTH DISTRICT*City of Birth PLACE OF BIRTH PROVINCE*State/Province of Birth COUNTRY OF BIRTH*Country/Region of BirthSelectTurkeyAfghanistanGermanyArgentinaAlbaniaAustraliaAustriaAzerbaijanBahrainBangladeshBelgiumBelarusUnited Arab EmiratesBoliviaBosnia and HerzegovinaBrazilBulgariaDjiboutiAlgeriaCzech RepublicChinaDenmarkIndonesiaArmeniaEstoniaMoroccoPhilippinesState of PalestineFinlandFranceGabonGeorgiaIndiaNetherlandsCroatiaIraqIrelandIranSpainIsraelSwedenSwitzerlandItalyJapanCanadaMontenegroQatarKazakhstanKuwaitCyprusKyrgyzstanLatviaLibyaLithuaniaLebanonLuxembourgHungaryMacedoniaMalaysiaMexicoMoldovaMozambiqueMyanmarEgyptNepalNigerNorwayUzbekistanPakistanPolandPortugalRussiaSenegalSingaporeSlovakiaSloveniaSomaliaSudanSyriaSaudi ArabiaSerbiaChileTajikistanTanzaniaThailandTaiwanTunisiaTurkmenistanUgandaUkraineOmanUnited KingdomUnited StatesUruguayJordanVenezuelaVietnamYemenGreece Personal Information 2Personal Information 2COUNTRY OF BIRTH*Country/Region of Origin (Nationality)SelectTurkeyAfghanistanGermanyArgentinaAlbaniaAustraliaAustriaAzerbaijanBahrainBangladeshBelgiumBelarusUnited Arab EmiratesBoliviaBosnia and HerzegovinaBrazilBulgariaDjiboutiAlgeriaCzech RepublicChinaDenmarkIndonesiaArmeniaEstoniaMoroccoPhilippinesState of PalestineFinlandFranceGabonGeorgiaIndiaNetherlandsCroatiaIraqIrelandIranSpainIsraelSwedenSwitzerlandItalyJapanCanadaMontenegroQatarKazakhstanKuwaitCyprusKyrgyzstanLatviaLibyaLithuaniaLebanonLuxembourgHungaryMacedoniaMalaysiaMexicoMoldovaMozambiqueMyanmarEgyptNepalNigerNorwayUzbekistanPakistanPolandPortugalRussiaSenegalSingaporeSlovakiaSloveniaSomaliaSudanSyriaSaudi ArabiaSerbiaChileTajikistanTanzaniaThailandTaiwanTunisiaTurkmenistanUgandaUkraineOmanUnited KingdomUnited StatesUruguayJordanVenezuelaVietnamYemenGreecePASSPORT NO*Passport Number PASSPORT ISSUING COUNTRY*Country/Authority that Issued DocumentSelectTurkeyAfghanistanGermanyArgentinaAlbaniaAustraliaAustriaAzerbaijanBahrainBangladeshBelgiumBelarusUnited Arab EmiratesBoliviaBosnia and HerzegovinaBrazilBulgariaDjiboutiAlgeriaCzech RepublicChinaDenmarkIndonesiaArmeniaEstoniaMoroccoPhilippinesState of PalestineFinlandFranceGabonGeorgiaIndiaNetherlandsCroatiaIraqIrelandIranSpainIsraelSwedenSwitzerlandItalyJapanCanadaMontenegroQatarKazakhstanKuwaitCyprusKyrgyzstanLatviaLibyaLithuaniaLebanonLuxembourgHungaryMacedoniaMalaysiaMexicoMoldovaMozambiqueMyanmarEgyptNepalNigerNorwayUzbekistanPakistanPolandPortugalRussiaSenegalSingaporeSlovakiaSloveniaSomaliaSudanSyriaSaudi ArabiaSerbiaChileTajikistanTanzaniaThailandTaiwanTunisiaTurkmenistanUgandaUkraineOmanUnited KingdomUnited StatesUruguayJordanVenezuelaVietnamYemenGreecePASSPORT ISSUE DATE*Issuance DateDay12345678910111213141516171819202122232425262728293031Month123456789101112Year2026202520242023202220212020201920182017201620152014PASSPORT EXPIRATION DATE*Expiration DateDay12345678910111213141516171819202122232425262728293031Month123456789101112Year203520342033203220312030202920282027202620252024DO / DID YOU HAVE A SECOND CITIZENSHIP?*Do you hold or have you held any nationality other than the one you have indicated above? YES NO OTHER COUNTRY OF CITIZENSHIP*Other Country/Region of OriginSelectTurkeyAfghanistanGermanyArgentinaAlbaniaAustraliaAustriaAzerbaijanBahrainBangladeshBelgiumBelarusUnited Arab EmiratesBoliviaBosnia and HerzegovinaBrazilBulgariaDjiboutiAlgeriaCzech RepublicChinaDenmarkIndonesiaArmeniaEstoniaMoroccoPhilippinesState of PalestineFinlandFranceGabonGeorgiaIndiaNetherlandsCroatiaIraqIrelandIranSpainIsraelSwedenSwitzerlandItalyJapanCanadaMontenegroQatarKazakhstanKuwaitCyprusKyrgyzstanLatviaLibyaLithuaniaLebanonLuxembourgHungaryMacedoniaMalaysiaMexicoMoldovaMozambiqueMyanmarEgyptNepalNigerNorwayUzbekistanPakistanPolandPortugalRussiaSenegalSingaporeSlovakiaSloveniaSomaliaSudanSyriaSaudi ArabiaSerbiaChileTajikistanTanzaniaThailandTaiwanTunisiaTurkmenistanUgandaUkraineOmanUnited KingdomUnited StatesUruguayJordanVenezuelaVietnamYemenGreeceDO YOU HAVE A PASSPORT OF YOUR SECOND NATIONALITY?*Do you hold a passport from the country/region of origin (nationality) above? YES NO PASSPORT NUMBER FOR OTHER NATIONALITY*Passport Number Current and Previous Address InformationPresent and Previous Address InformationYOUR CURRENT ADDRESS* ADDRESS LINE 2 (OPTIONAL) CITY/TOWN* DISTRICT/PROVINCE/STATE* POSTAL CODE COUNTRY*SelectTurkeyAfghanistanGermanyArgentinaAlbaniaAustraliaAustriaAzerbaijanBahrainBangladeshBelgiumBelarusUnited Arab EmiratesBoliviaBosnia and HerzegovinaBrazilBulgariaDjiboutiAlgeriaCzech RepublicChinaDenmarkIndonesiaArmeniaEstoniaMoroccoPhilippinesState of PalestineFinlandFranceGeorgiaIndiaNetherlandsCroatiaIraqIrelandIranSpainIsraelSwedenSwitzerlandItalyJapanCanadaMontenegroQatarKazakhstanKuwaitCyprusKyrgyzstanLatviaLibyaLithuaniaLebanonLuxembourgHungaryMacedoniaMalaysiaMexicoMoldovaMontenegroMozambiqueMyanmarEgyptNepalNigerNorwayUzbekistanPakistanPolandPortugalRussiaSenegalSingaporeSlovakiaSloveniaSomaliaSudanSyriaSaudi ArabiaSerbiaChileTajikistanTanzaniaThailandTaiwanTunisiaTurkmenistanUgandaUkraineOmanUnited KingdomUnited StatesUruguayJordanVenezuelaVietnamYemenGreeceWHEN DID YOU MOVE TO THIS ADDRESS?*Started Living HereDay12345678910111213141516171819202122232425262728293031Month123456789101112Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920SINCE THE AGE OF 16, HAVE YOU LIVED AT ANOTHER ADDRESS?*Have you lived anywhere other than this address since the age of sixteen? YES NO ADDRESSES WHERE YOU HAVE LIVED SINCE THE AGE OF 16Please provide the following information on all addresses you lived at since turning sixteen. Begin with your address immediately before your current address. YOUR PREVIOUS ADDRESS ADDRESS LINE 2 (OPTIONAL) PROVINCE DISTRICT/PROVINCE/STATE POSTAL CODE COUNTRY WHEN DID YOU MOVE TO THIS ADDRESS? HOW LONG DID YOU LIVE AT THIS ADDRESS? Actions Edit Sil Addresses Add Address Maximum number of addresses reached. Phone, E-Mail and Social MediaPhone, Email and Social MediaPRIMARY PHONE NUMBER*Primary Phone Number SECONDARY PHONE NUMBERSecondary Phone Number WORK PHONE NUMBERWork Phone Number HAVE YOU USED ANY OTHER PHONE NUMBERS IN THE LAST 5 YEARS?*Have you used any other telephone numbers during the last five years? YES NO OTHER PHONE NUMBER USED*Other Telephone Number Used E-MAIL ADDRESS*Email Address HAVE YOU USED ANOTHER E-MAIL ADDRESS IN THE LAST 5 YEARS?*Have you used any other email addresses during the last five years? YES NO OTHER E-MAIL ADDRESS USED*Other Email Address Used SOCIAL MEDIA ACCOUNTS YOU HAVE USED IN THE LAST 5 YEARSSelect from the list below each media platform you have used within the last five years. SOCIAL MEDIA PLATFORM SOCIAL MEDIA ACCOUNT NAME Actions Edit Sil Social Media Accounts. Add Social Media Account Maximum number of social media accounts reached. US Address to which your Green Card will be sentAddress in the United States where you want your Permanent Residence Card (Green Card) mailedPERSON LIVING AT THE ADDRESS NAME SURNAME*Contact Person US ADDRESS*U.S. Street Address (Line 1) ADDRESS LINE 2 (OPTIONAL)U.S. Street Address (Line 2) CITY*City STATE*StateSelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificPOSTAL CODE*Zip Code PHONE NUMBERPhone Number Your Father's DetailsFatherYOUR FATHER'S SURNAME*Surnames FATHER'S NAME*Given Names YOUR FATHER'S DATE OF BIRTH*Date of BirthDay12345678910111213141516171819202122232425262728293031Month123456789101112Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920DISTRICT OF YOUR FATHER'S BIRTHPLACE*City of Birth PROVINCE OF YOUR FATHER'S BIRTHPLACE*State/Province of Birth YOUR FATHER'S COUNTRY OF BIRTH*Country/Region of BirthSelectTurkeyAfghanistanGermanyArgentinaAlbaniaAustraliaAustriaAzerbaijanBahrainBangladeshBelgiumBelarusUnited Arab EmiratesBoliviaBosnia and HerzegovinaBrazilBulgariaDjiboutiAlgeriaCzech RepublicChinaDenmarkIndonesiaArmeniaEstoniaMoroccoPhilippinesState of PalestineFinlandFranceGabonGeorgiaIndiaNetherlandsCroatiaIraqIrelandIranSpainIsraelSwedenSwitzerlandItalyJapanCanadaMontenegroQatarKazakhstanKuwaitCyprusKyrgyzstanLatviaLibyaLithuaniaLebanonLuxembourgHungaryMacedoniaMalaysiaMexicoMoldovaMozambiqueMyanmarEgyptNepalNigerNorwayUzbekistanPakistanPolandPortugalRussiaSenegalSingaporeSlovakiaSloveniaSomaliaSudanSyriaSaudi ArabiaSerbiaChileTajikistanTanzaniaThailandTaiwanTunisiaTurkmenistanUgandaUkraineOmanUnited KingdomUnited StatesUruguayJordanVenezuelaVietnamYemenGreeceIS YOUR FATHER ALIVE?*Is your father still living? YES NO YEAR OF YOUR FATHER'S DEATH*Year of death YOUR FATHER'S ADDRESS* CONTINUATION OF YOUR FATHER'S ADDRESS PROVINCE WHERE YOUR FATHER LIVES* PROVINCE WHERE YOUR FATHER LIVES* POSTAL CODE OF THE ADDRESS WHERE YOUR FATHER LIVES YOUR FATHER'S COUNTRY OF RESIDENCE*SelectTurkeyAfghanistanGermanyArgentinaAlbaniaAustraliaAustriaAzerbaijanBahrainBangladeshBelgiumBelarusUnited Arab EmiratesBoliviaBosnia and HerzegovinaBrazilBulgariaDjiboutiAlgeriaCzech RepublicChinaDenmarkIndonesiaArmeniaEstoniaMoroccoPhilippinesState of PalestineFinlandFranceGabonGeorgiaIndiaNetherlandsCroatiaIraqIrelandIranSpainIsraelSwedenSwitzerlandItalyJapanCanadaMontenegroQatarKazakhstanKuwaitCyprusKyrgyzstanLatviaLibyaLithuaniaLebanonLuxembourgHungaryMacedoniaMalaysiaMexicoMoldovaMozambiqueMyanmarEgyptNepalNigerNorwayUzbekistanPakistanPolandPortugalRussiaSenegalSingaporeSlovakiaSloveniaSomaliaSudanSyriaSaudi ArabiaSerbiaChileTajikistanTanzaniaThailandTaiwanTunisiaTurkmenistanUgandaUkraineOmanUnited KingdomUnited StatesUruguayJordanVenezuelaVietnamYemenGreeceYour Mother's InformationMotherYOUR MOTHER'S MAIDEN NAME*Surnames at Birth YOUR MOTHER'S NAME*Given Names YOUR MOTHER'S DATE OF BIRTH*Date of BirthDay12345678910111213141516171819202122232425262728293031Month123456789101112Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920DISTRICT OF YOUR MOTHER'S BIRTHPLACE*City of Birth PROVINCE OF YOUR MOTHER'S BIRTH*State/Province of Birth YOUR MOTHER'S COUNTRY OF BIRTH*Country/Region of BirthSelectTurkeyAfghanistanGermanyArgentinaAlbaniaAustraliaAustriaAzerbaijanBahrainBangladeshBelgiumBelarusUnited Arab EmiratesBoliviaBosnia and HerzegovinaBrazilBulgariaDjiboutiAlgeriaCzech RepublicChinaDenmarkIndonesiaArmeniaEstoniaMoroccoPhilippinesState of PalestineFinlandFranceGabonGeorgiaIndiaNetherlandsCroatiaIraqIrelandIranSpainIsraelSwedenSwitzerlandItalyJapanCanadaMontenegroQatarKazakhstanKuwaitCyprusKyrgyzstanLatviaLibyaLithuaniaLebanonLuxembourgHungaryMacedoniaMalaysiaMexicoMoldovaMozambiqueMyanmarEgyptNepalNigerNorwayUzbekistanPakistanPolandPortugalRussiaSenegalSingaporeSlovakiaSloveniaSomaliaSudanSyriaSaudi ArabiaSerbiaChileTajikistanTanzaniaThailandTaiwanTunisiaTurkmenistanUgandaUkraineOmanUnited KingdomUnited StatesUruguayJordanVenezuelaVietnamYemenGreeceIS YOUR MOTHER ALIVE?*Is your mother still living? YES NO DOES YOUR MOTHER LIVE AT THE SAME ADDRESS AS YOUR FATHER?*Does your mother live in the same address as your father? YES NO YEAR OF YOUR MOTHER'S DEATH*Year of death YOUR MOTHER'S ADDRESS* YOUR MOTHER'S ADDRESS CONTINUATION PROVINCE WHERE YOUR MOTHER LIVES* PROVINCE WHERE YOUR MOTHER LIVES* POSTAL CODE OF THE ADDRESS WHERE YOUR MOTHER LIVES YOUR MOTHER'S COUNTRY OF RESIDENCE*SelectTurkeyAfghanistanGermanyArgentinaAlbaniaAustraliaAustriaAzerbaijanBahrainBangladeshBelgiumBelarusUnited Arab EmiratesBoliviaBosnia and HerzegovinaBrazilBulgariaDjiboutiAlgeriaCzech RepublicChinaDenmarkIndonesiaArmeniaEstoniaMoroccoPhilippinesState of PalestineFinlandFranceGeorgiaIndiaNetherlandsCroatiaIraqIrelandIranSpainIsraelSwedenSwitzerlandItalyJapanCanadaMontenegroQatarKazakhstanKuwaitCyprusKyrgyzstanLatviaLibyaLithuaniaLebanonLuxembourgHungaryMacedoniaMalaysiaMexicoMoldovaMontenegroMozambiqueMyanmarEgyptNepalNigerNorwayUzbekistanPakistanPolandPortugalRussiaSenegalSingaporeSlovakiaSloveniaSomaliaSudanSyriaSaudi ArabiaSerbiaChileTajikistanTanzaniaThailandTaiwanTunisiaTurkmenistanUgandaUkraineOmanUnited KingdomUnited StatesUruguayJordanVenezuelaVietnamYemenGreeceSpouse InformationCurrent SpousesSPOUSE'S SURNAME*Surnames YOUR WIFE'S NAME*Given Names YOUR SPOUSE'S DATE OF BIRTH*Date of BirthDay12345678910111213141516171819202122232425262728293031Month123456789101112Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920PROVINCE OF YOUR SPOUSE'S BIRTHPLACE*City of Birth PROVINCE OF YOUR SPOUSE'S BIRTHPLACE*State/Province of Birth YOUR SPOUSE'S COUNTRY OF BIRTH*Country/Region of BirthSelectTurkeyAfghanistanGermanyArgentinaAlbaniaAustraliaAustriaAzerbaijanBahrainBangladeshBelgiumBelarusUnited Arab EmiratesBoliviaBosnia and HerzegovinaBrazilBulgariaDjiboutiAlgeriaCzech RepublicChinaDenmarkIndonesiaArmeniaEstoniaMoroccoPhilippinesState of PalestineFinlandFranceGabonGeorgiaIndiaNetherlandsCroatiaIraqIrelandIranSpainIsraelSwedenSwitzerlandItalyJapanCanadaMontenegroQatarKazakhstanKuwaitCyprusKyrgyzstanLatviaLibyaLithuaniaLebanonLuxembourgHungaryMacedoniaMalaysiaMexicoMoldovaMozambiqueMyanmarEgyptNepalNigerNorwayUzbekistanPakistanPolandPortugalRussiaSenegalSingaporeSlovakiaSloveniaSomaliaSudanSyriaSaudi ArabiaSerbiaChileTajikistanTanzaniaThailandTaiwanTunisiaTurkmenistanUgandaUkraineOmanUnited KingdomUnited StatesUruguayJordanVenezuelaVietnamYemenGreeceYOUR SPOUSE'S OCCUPATION*OccupationSelectAGRICULTUREARTIST/PERFORMERBUSINESSCOMMUNICATIONSCOMPUTER SCIENCECULINARY/FOOD SERVICESEDUCATIONENGINEERINGGOVERNMENTHOMEMAKERLEGAL PROFESSIONMEDICAL/HEALTHMILITARYNATURAL SCIENCENOT EMPLOYEDPHYSICAL SCIENCESRELIGIOUS VOCATIONRESEARCHRETIREDSOCIAL SCIENCESTUDENTOTHERDATE OF MARRIAGE*Date of MarriageDay12345678910111213141516171819202122232425262728293031Month123456789101112Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920PLACE OF MARRIAGE DISTRICT*Place of Marriage City PLACE OF MARRIAGE PROVINCE*Place of Marriage State IN WHICH COUNTRY DID YOU GET MARRIED?*Place of Marriage CountrySelectTurkeyAfghanistanGermanyArgentinaAlbaniaAustraliaAustriaAzerbaijanBahrainBangladeshBelgiumBelarusUnited Arab EmiratesBoliviaBosnia and HerzegovinaBrazilBulgariaDjiboutiAlgeriaCzech RepublicChinaDenmarkIndonesiaArmeniaEstoniaMoroccoPhilippinesState of PalestineFinlandFranceGabonGeorgiaIndiaNetherlandsCroatiaIraqIrelandIranSpainIsraelSwedenSwitzerlandItalyJapanCanadaMontenegroQatarKazakhstanKuwaitCyprusKyrgyzstanLatviaLibyaLithuaniaLebanonLuxembourgHungaryMacedoniaMalaysiaMexicoMoldovaMozambiqueMyanmarEgyptNepalNigerNorwayUzbekistanPakistanPolandPortugalRussiaSenegalSingaporeSlovakiaSloveniaSomaliaSudanSyriaSaudi ArabiaSerbiaChileTajikistanTanzaniaThailandTaiwanTunisiaTurkmenistanUgandaUkraineOmanUnited KingdomUnited StatesUruguayJordanVenezuelaVietnamYemenGreeceWILL YOUR SPOUSE IMMIGRATE TO THE USA WITH YOU?*Is your spouse immigrating to the U.S. with you? YES NO Former Spouse InformationPrevious SpousesDO YOU HAVE AN EX-WIFE?*Do you have any previous spouses? YES NO YOUR EX-SPOUSE'S LAST NAME*Surnames EX-WIFE'S NAME*Given Names YOUR EX-SPOUSE'S DATE OF BIRTH*Date of BirthDay12345678910111213141516171819202122232425262728293031Month123456789101112Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920DATE OF MARRIAGE WITH EX-SPOUSE*Date of MarriageDay12345678910111213141516171819202122232425262728293031Month123456789101112Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920END DATE OF MARRIAGE WITH EX-SPOUSE*Date Marriage EndedDay12345678910111213141516171819202122232425262728293031Month123456789101112Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920HOW DID YOUR MARRIAGE END?*How was your marriage terminated?SelectDEATHDIVORCEIN WHICH COUNTRY DID YOUR MARRIAGE END?*Country/Region where marriage was terminatedSelectTurkeyAfghanistanGermanyArgentinaAlbaniaAustraliaAustriaAzerbaijanBahrainBangladeshBelgiumBelarusUnited Arab EmiratesBoliviaBosnia and HerzegovinaBrazilBulgariaDjiboutiAlgeriaCzech RepublicChinaDenmarkIndonesiaArmeniaEstoniaMoroccoPhilippinesState of PalestineFinlandFranceGabonGeorgiaIndiaNetherlandsCroatiaIraqIrelandIranSpainIsraelSwedenSwitzerlandItalyJapanCanadaMontenegroQatarKazakhstanKuwaitCyprusKyrgyzstanLatviaLibyaLithuaniaLebanonLuxembourgHungaryMacedoniaMalaysiaMexicoMoldovaMozambiqueMyanmarEgyptNepalNigerNorwayUzbekistanPakistanPolandPortugalRussiaSenegalSingaporeSlovakiaSloveniaSomaliaSudanSyriaSaudi ArabiaSerbiaChileTajikistanTanzaniaThailandTaiwanTunisiaTurkmenistanUgandaUkraineOmanUnited KingdomUnited StatesUruguayJordanVenezuelaVietnamYemenGreeceChildrenChildrenYOUR CHILDREN'S INFORMATIONProvide the following information on each of your children (this includes all natural children, adopted children, and step children). YOUR CHILD'S SURNAME YOUR CHILD'S NAME YOUR CHILD'S DATE OF BIRTH PROVINCE WHERE YOUR CHILD WAS BORN PROVINCE WHERE YOUR CHILD WAS BORN YOUR CHILD'S COUNTRY OF BIRTH DOES YOUR CHILD LIVE WITH YOU? WILL YOUR CHILD IMMIGRATE TO THE USA WITH YOU? Actions Edit Sil Children. Add a Child Maximum number of Children reached. US VisitsPrevious U.S. Travel InformationHAVE YOU BEEN TO THE USA BEFORE?*Have you ever been in the U.S.? YES NO HAVE YOU RECEIVED A FOREIGNER REGISTRATION NUMBER BEFORE?*Were you issued an Alien Registration Number by the Department of Homeland Security? YES NO FOREIGNER REGISTRATION NUMBER*Alien Registration Number ENTER YOUR LAST 5 US VISITSProvide information on your last 5 U.S. visits US ENTRY DATE HOW MANY DAYS DID YOU STAY IN THE USA? Actions Edit Sil Visits Add a Visit Maximum number of visits reached. HAVE YOU EVER GOTTEN A US VISA BEFORE?*Have you ever been issued a U.S. Visa? Click for Sample U.S. Visa YES NO USA VISA ISSUANCE DATE*Date Visa Was IssuedDay12345678910111213141516171819202122232425262728293031Month123456789101112Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920VISA TYPE*Visa ClassificationSelectBUSINESS & TOURISM (B1/B2)BUSINESS / CONFERENCE (B1)TOURISM / MEDICAL TREATMENT (B2)STUDENT (F1)WORK & TRAVEL (J1)VISA NUMBER*Visa Number HAS YOUR USA VISA (PASSPORT) BEEN STOLEN OR LOST?*Have any of your U.S. visas ever been lost or stolen? YES NO HAS YOUR US VISA BEEN CANCELED?*Have any of your U.S. visas ever been cancelled or revoked? YES NO HAVE YOU BEEN DENIED A USA VISA OR ENTRY INTO THE USA?*Have you ever been refused a U.S. visa, been refused admission to the United States, or withdrawn your application for admission at the port of entry? YES NO VISA DENIAL*Explain Work ExperienceWorkPRIMARY OCCUPATION*Primary OccupationSelectAGRICULTUREARTIST/PERFORMERBUSINESSCOMMUNICATIONSCOMPUTER SCIENCECULINARY/FOOD SERVICESEDUCATIONENGINEERINGGOVERNMENTHOMEMAKERLEGAL PROFESSIONMEDICAL/HEALTHMILITARYNATURAL SCIENCENOT EMPLOYEDPHYSICAL SCIENCESRELIGIOUS VOCATIONRESEARCHRETIREDSOCIAL SCIENCESTUDENTOTHERSPECIFY OTHER OCCUPATION*Specify Other CURRENT WORKPLACE OR SCHOOL NAME*Present Employer or School Name CURRENT WORKPLACE OR SCHOOL ADDRESS*Present Employer or School address ADDRESS LINE 2 (OPTIONAL) CITY/TOWN* DISTRICT/PROVINCE/STATE* POSTAL CODE COUNTRY*SelectTurkeyAfghanistanGermanyArgentinaAlbaniaAustraliaAustriaAzerbaijanBahrainBangladeshBelgiumBelarusUnited Arab EmiratesBoliviaBosnia and HerzegovinaBrazilBulgariaDjiboutiAlgeriaCzech RepublicChinaDenmarkIndonesiaArmeniaEstoniaMoroccoPhilippinesState of PalestineFinlandFranceGeorgiaIndiaNetherlandsCroatiaIraqIrelandIranSpainIsraelSwedenSwitzerlandItalyJapanCanadaMontenegroQatarKazakhstanKuwaitCyprusKyrgyzstanLatviaLibyaLithuaniaLebanonLuxembourgHungaryMacedoniaMalaysiaMexicoMoldovaMontenegroMozambiqueMyanmarEgyptNepalNigerNorwayUzbekistanPakistanPolandPortugalRussiaSenegalSingaporeSlovakiaSloveniaSomaliaSudanSyriaSaudi ArabiaSerbiaChileTajikistanTanzaniaThailandTaiwanTunisiaTurkmenistanUgandaUkraineOmanUnited KingdomUnited StatesUruguayJordanVenezuelaVietnamYemenGreeceDOES THIS JOB REQUIRE AT LEAST 2 YEARS OF EDUCATION OR EXPERIENCE?*Does this job require at least 2 years of training or experience? YES NO JOB TITLE*Job Title DUTIES*DutiesSTART DATE*Employment Date FromDay12345678910111213141516171819202122232425262728293031Month123456789101112Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920DO YOU HAVE ANY OTHER OCCUPATION?*Do you have other occupations? YES NO OTHER PROFESSION*Other OccupationSelectAGRICULTUREARTIST/PERFORMERBUSINESSCOMMUNICATIONSCOMPUTER SCIENCECULINARY/FOOD SERVICESEDUCATIONENGINEERINGGOVERNMENTHOMEMAKERLEGAL PROFESSIONMEDICAL/HEALTHMILITARYNATURAL SCIENCENOT EMPLOYEDPHYSICAL SCIENCESRELIGIOUS VOCATIONRESEARCHRETIREDSOCIAL SCIENCESTUDENTOTHERWHAT PROFESSION DO YOU PLAN TO WORK IN THE USA?*In which occupation do you intend to work in the U.S.?SelectAGRICULTUREARTIST/PERFORMERBUSINESSCOMMUNICATIONSCOMPUTER SCIENCECULINARY/FOOD SERVICESEDUCATIONENGINEERINGGOVERNMENTHOMEMAKERLEGAL PROFESSIONMEDICAL/HEALTHMILITARYNATURAL SCIENCEPHYSICAL SCIENCESRELIGIOUS VOCATIONRESEARCHSOCIAL SCIENCESTUDENTOTHERHAVE YOU WORKED BEFORE?*Were you previously employed? YES NO FORMER WORKPLACES (LAST 10 YEARS)Provide the following information on all of your employers from the last ten years, starting with the most recent employer. WORKPLACE NAME WORKPLACE ADDRESS WORKPLACE ADDRESS CONTINUED PROVINCE DISTRICT/PROVINCE/STATE POSTAL CODE COUNTRY WORKPLACE PHONE NUMBER YOUR JOB TITLE NAME AND SURNAME OF YOUR MANAGER START DATE DATE OF LEAVING THE WORKPLACE DOES THIS JOB REQUIRE AT LEAST 2 YEARS OF EDUCATION OR EXPERIENCE? DUTIES Actions Edit Sil Workplaces. Add Workplace Maximum number of Workplaces reached. EducationEducationHAVE YOU COMPLETED HIGH SCHOOL AND ABOVE?*Have you attended any educational Institutions at a secondary level or above? YES NO HIGHEST LEVEL OF EDUCATION COMPLETED*Highest Level of Education CompletedSelectHIGH SCHOOL DROPOUTHIGH SCHOOL GRADUATEVOCATIONAL HIGH SCHOOL GRADUATEUNIVERSITY DROPOUTUNIVERSITY GRADUATEMASTER GRADUATEOTHERHIGH SCHOOL AND ABOVEProvide the following information on all educational institutions at a secondary level or above you have attended. SCHOOL NAME SCHOOL ADDRESS SCHOOL ADDRESS CONTINUED PROVINCE DISTRICT/PROVINCE/STATE POSTAL CODE COUNTRY THE DEPARTMENT YOU HAVE COMPLETED THE DOCUMENT YOU RECEIVED UPON GRADUATION SCHOOL START DATE END OF SCHOOL DATE Actions Edit Sil Schools. Add School Maximum number of schools reached. EkAdditionalHAVE YOU TRAVELED TO ANY COUNTRY IN THE LAST 5 YEARS?*Have you traveled to any countries/regions within the last five years? YES NO COUNTRIES YOU HAVE TRAVELED TO IN THE LAST 5 YEARSProvide the list of countries/regions visited COUNTRY TRAVELED TO Actions Edit Sil Countries Add Country Maximum number of Countries reached. CAN YOU SPEAK AND/OR READ ANOTHER LANGUAGE OTHER THAN YOUR MOTHER TONGUE?*Can you speak and/or read languages other than your native language? YES NO FOREIGN LANGUAGESList the languages that you speak and/or read FOREIGN LANGUAGE Actions Edit Sil Languages. Add Language Maximum number of dillers reached. DID YOU DO MILITARY SERVICE?*Have you ever served in the military? YES NO COUNTRY OF MILITARY SERVICE*Name of Country/RegionSelectTurkeyAfghanistanGermanyArgentinaAlbaniaAustraliaAustriaAzerbaijanBahrainBangladeshBelgiumBelarusUnited Arab EmiratesBoliviaBosnia and HerzegovinaBrazilBulgariaDjiboutiAlgeriaCzech RepublicChinaDenmarkIndonesiaArmeniaEstoniaMoroccoPhilippinesState of PalestineFinlandFranceGeorgiaIndiaNetherlandsCroatiaIraqIrelandIranSpainIsraelSwedenSwitzerlandItalyJapanCanadaMontenegroQatarKazakhstanKuwaitCyprusKyrgyzstanLatviaLibyaLithuaniaLebanonLuxembourgHungaryMacedoniaMalaysiaMexicoMoldovaMontenegroMozambiqueMyanmarEgyptNepalNigerNorwayUzbekistanPakistanPolandPortugalRussiaSenegalSingaporeSlovakiaSloveniaSomaliaSudanSyriaSaudi ArabiaSerbiaChileTajikistanTanzaniaThailandTaiwanTunisiaTurkmenistanUgandaUkraineOmanUnited KingdomUnited StatesUruguayJordanVenezuelaVietnamYemenGreeceCOMMAND*Branch of Service RANK*Rank/Position SPECIALIZATION*Military Specialty MILITARY SERVICE START DATE*Date of Service FromDay12345678910111213141516171819202122232425262728293031Month123456789101112Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920END DATE OF MILITARY SERVICE*Date of Service ToDay12345678910111213141516171819202122232425262728293031Month123456789101112Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920HAVE YOU APPLIED FOR A US SOCIAL SECURITY NUMBER (SSN)?*Have you ever applied for a Social Security number? YES NO DID YOU GET SSN NUMBER?*Were you issued a number? YES NO SOCIAL SECURITY NUMBER*Social Security Number CheckReview{all_fields:exclude[9,13,127, 147,148,157,171,193,194,197,245,214,246,125,248,251]}APPROVAL* I have checked all the information I have entered and confirm that it is correct*