ENTER APPLICANT INFORMATION

Please provide all responses in English.
Required fields are indicated by a red asterisk *.

In the Family Name field, 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.

In the First (Given) Name field, 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. The 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.

Gender *

In the Day field, 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. In the Month field, 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. In the Year field, choose the year in which you were born. The year of birth is required to complete the application and to check the status of your application.

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.

Choose the country in which you were born. The country where you were born is required to complete the application.

"Enter the email address at which you can be contacted. The email address is required to complete the application. If you do not have an email address, you may provide an alternative third-party email address belonging to a point of contact (e.g. a family member, friend or business associate.)

Confirm the email address at which you can be contacted.

"Enter the alternative email address at which you can be contacted. The email address is required to complete the application. If you do not have an email address, you may provide an alternative third-party email address belonging to a point of contact (e.g. a family member, friend or business associate.)

Are you known by any other names or aliases? *

APPLICANT / PASSPORT INFORMATION

Enter your document number as it appears on your travel document. The travel document may contain numbers and/or characters. Please closely distinguish between the number zero and the letter O.

Choose the country of citizenship, as it appears on your passport. The country of citizenship is required to complete the application.

Choose the country of citizenship, as it appears on your passport. The passport issuing country is required to complete the application.

In the Day field, 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. In the Month field, 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. In the Year field, 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.

In the Day field, choose the day on which your passport expires, as it appears on your passport under the Expiration Date field. The day on which the passport expires is required to complete the application. In the Month field, choose the month in which your passport expires, as it appears on your passport under the Expiration Date field. The month in which the passport expires is required to complete the application. In the Year field, choose the year in which your passport expires, as it appears on your passport under the Expiration Date field. The year in which the passport expires is required to complete the application.

Have you ever been issued a passport or national identity card for travel by any other country? *

OTHER CITIZENSHIP/NATIONALITY

Are you now a citizen or national of any other country?*
Have you ever been a citizen or national of any other country? *

GE MEMBERSHIP

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

PARENTS

Please list your parents names in the boxes to the right. All applicants are required to fill out this section.

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.

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 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. The 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.

YOUR CONTACT INFORMATION

Please enter your contact information below.

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.

In the City field, enter the city, town, village, or hamlet. The city, town, village, or hamlet is required to complete the application.

In the State/Province/Region field, enter the state, province, or region. The state/province/region is required to complete the application.

In the Country field, choose the country. The country is required to complete the application.

At least one telephone number is required to complete the application. If you do not have a telephone number, you may provide an alternative third-party telephone number belonging to a point of contact (e.g. a family member, friend, or business associate). In the Type field, choose the type of the telephone number where you may be contacted. The telephone type is required to complete the application.

At least one telephone number is required to complete the application. If you do not have a telephone number, you may provide an alternative third-party telephone number belonging to a point of contact (e.g. a family member, friend, or business associate). In the Type field, choose the type of the telephone number where you may be contacted. The telephone type is required to complete the application.

At least one telephone number is required to complete the application. If you do not have a telephone number, you may provide an alternative third-party telephone number belonging to a point of contact (e.g. a family member, friend, or business associate). In the Country Code field, enter the country code of the telephone number where you may be contacted. The country code is required to complete the application. In the Phone field, enter the telephone number where you may be contacted. The telephone number is required to complete the application.

EMPLOYMENT INFORMATION

Do you have a current or previous employer? *

ENTER TRAVEL INFORMATION

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

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

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.

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.

"Enter your emergency contact's email address. Email address is required to complete the application.

At least one telephone number is required to complete the application. If you do not have a telephone number, you may provide an alternative third-party telephone number belonging to a point of contact (e.g. a family member, friend, or business associate). In the Type field, choose the type of the telephone number where you may be contacted. The telephone type is required to complete the application.

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. In the Phone field, enter your emergency contact's telephone number. The telephone number is required to complete the application. If you do not have an emergency contact telephone number you may enter zeros.

ELIGIBILITY QUESTIONS

Need additional guidance on eligibility questions?

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

  • - Cholera
  • - Diphtheria
  • - Tuberculosis, infectious
  • - Plague
  • - Smallpox
  • - Yellow Fever
  • - Viral Hemorrhagic Fevers, including Ebola, Lassa, Marburg, Crimean-Congo
  • - Severe acute respiratory illnesses capable of transmission to other persons and likely to cause mortality.

2) Have you ever been arrested or convicted for a crime that resulted in serious damage to property, or serious harm to another person or government authority? *

3) Have you ever violated any law related to possessing, using, or distributing illegal drugs? *

4) Do you seek to engage in or have you ever engaged in terrorist activities, espionage, sabotage, or genocide? *

5) Have you ever committed fraud or misrepresented yourself or others to obtain, or assist others to obtain, a visa or entry into the United States? *

6) Are you currently seeking employment in the United States or were you previously employed in the United States without prior permission from the U.S. government? *

7) Have you ever been denied a U.S. visa you applied for with your current or previous passport, or have you ever been refused admission to the United States or withdrawn your application for admission at a U.S. port of entry? *

8) Have you ever stayed in the United States longer than the admission period granted to you by the U.S. government? *

9) Have you traveled to, or been present in Iraq, Syria, Iran, Sudan, Libya, Somalia or Yemen on or after March 1, 2011? *