We use cookies to ensure that we provide the best user experience on our website. If you continue to use this site we will assume that you agree. More information

Accept
1 Personal and Travel Information
2 Confirm your details
3 Payment method
Please provide all responses in English

Applicant Information

Please provide your Given Name(s) (also known as "First Name") exactly as shown on your passport or identity document. ?

Enter your First Name as shown on your passport This field is required.
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. ?

Enter your Family Name as shown on your passport This field is required.
Select one of the options
In the Birth Date field, chose the day on which you were born. The day of birth is required to complete the application ?
Select a correct date
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. ?
This field is required.
In the Country field, choose the country. The country is required to complete the application. ?
This field is required.
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. ?
This field is required.
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. ?
This field is required.
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. ?
This field is required.
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. ?
This field is required.

Contact Information

Enter the e-mail address at which you can be contacted. The e-mail address is required to complete the application. If you do not have an e-mail address, you may provide an alternative third-party e-mail address belonging to a point of contact (e.g. a family member, friend or business associate). ?
The email is not correct
Enter the e-mail address at which you can be contacted. The e-mail address is required to complete the application. If you do not have an e-mail address, you may provide an alternative third-party e-mail address belonging to a point of contact (e.g. a family member, friend or business associate). ?
Your email does not match
The 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 where you can be contacted (e.g. a family member, friend, or business associate). ?
This field is required.
In the Address Line 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 is required to complete the application. ?
This field is required.
In the Apartment Number field, enter apartment, suite, unit, or other, as appropriate. Do not include the city and state in this field. Apartment number is optional 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. ?
This field is required.
In the State/Province/Region field, enter the state, province, or region. The State/Province/Region is required to complete the application. ?
This field is required.
In the Country field, choose the country. The country is required to complete the application. ?
Select one option

Employment Information

Select one of the options
This field is required.
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. ?
This field is required.
Please enter the address (street and number) of your employer. ?
This field is required.
Please enter required Post Code. If you do not know the Post Code, enter two zeros (00) in order to proceed with 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. ?
Select one option

Emergency Contact Information In or Out of the United States

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. ?
This field is required.
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. ?
This field is required.
Enter your emergency contact's telephone number. The number is required to complete the application. If you do not know the telephone number, you may provide an alternative third-party telephone number (e.g. belonging to a family member, friend, or business associate). ?
Enter your emergency contact's e-mail address. E-mail address is required to complete the application. You may also enter UNKNOWN. ?

Travel Information

Select one of the options
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. ?
This field is required.
In the Address Line field, enter the number and street of your US point of contact's address. Do not include the city and state in this field. Address line is required to complete the application. You may also enter UNKNOWN. ?
This field is required.
In the City field, enter the city, town, village, or hamlet. The city, town, village, or hamlet is required to complete the application. ?
This field is required.

Passport Information*

Choose the country of citizenship, as it appears on your passport. The country of citizenship is required to complete the application. ?
Select one option
Choose the country of citizenship, as it appears on your passport. The passport issuing country is required to complete the application. ?
Select one option
This field is required.
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. ?
This field is required.
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. ?
Your passport number do not match
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. ?
Select a correct date
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. ?
Select a correct date
Select one of the options
Choose the country of citizenship, as it appears on your passport. The passport issuing country is required to complete the application. ?
Select one option
Please select the travel document type issued by another country. ?
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. ?
This field is required.
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. ?
Select a correct date
Select one of the options
In the Country field, choose the country. The country is required to complete the application. ?
Select one option
Please indicate how did you acquired citizenship/nationality. ?
Select one of the options
In the Country field, choose the country. The country is required to complete the application. ?
Select one option

GE Membership

Select one of the options
The Membership Number is exactly nine digits. It is labeled as Membership Number / PASSID and can be found by logging into your GOES account. ?
This field is required.

Do any of the following apply to you? (Change to Yes if applicable)

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
  • Difteria
  • Infectious tuberculosis
  • Plague
  • Smallpox2
  • Yellow fever
  • Viral Hemorrhagic Fevers, including Ebola, Lassa, Marburg virus disease, Crimean-Congo
  • Severe acute respiratory illnesses capable of transmission to other persons and likely to cause mortality
*You will be able to continue only if the selection is no.
You will be able to continue only if the selection is no.

*You will be able to continue only if the selection is no.
You will be able to continue only if the selection is no.

*You will be able to continue only if the selection is no.
You will be able to continue only if the selection is no.

*You will be able to continue only if the selection is no.
You will be able to continue only if the selection is no.

*You will be able to continue only if the selection is no.
You will be able to continue only if the selection is no.

*You will be able to continue only if the selection is no.
You will be able to continue only if the selection is no.

*You will be able to continue only if the selection is no.
You will be able to continue only if the selection is no.

*You will be able to continue only if the selection is no.
You will be able to continue only if the selection is no.

*You will be able to continue only if the selection is no.
You will be able to continue only if the selection is no.