Consult your passport and enter all the data in the same format.
Country of citizenship/nationality
How did you acquire citizenship/nationality of this country ?
Have you been a citizen or national of another country? *
IMPORTANT: Your application number will be sent to the email address listed below. You must verify your email address to complete your request.
Please give all answers in English.
Are you known by any other names or aliases ?
Have you ever had a passport or national identity card issued to you by another country to travel?
Your home address
Please provide the names of your parents:
Do you have a job?
Is your trip to the United States a transit to another country ?
Emergency Contact Information In Or Outside The United States
Do you have a copy of your passport to download?
In order to obtain your approved ESTA, you will need to email a copy of your passport.You will receive instructions after finalizing your file. Check your inbox for this purpose.
Do you suffer from a physical or mental illness, are you a drug addict or chronic drug addict or do you suffer from any of the following illnesses : Chancroid, Gonorrhea, Granuloma inguinale, Infectious leprosy, Lymphogranuloma venereum, Infectious syphilis, Active tuberculosis? :
Have you been arrested or convicted of an offense that caused serious property damage or serious harm to another person or government authority ?
Have you ever violated any law in connection with the possession, use or trafficking of illegal drugs ?
Do you intend to participate or have you participated in terrorist activities, espionage, sabotage or genocide ?
Have you ever committed fraud or misrepresented yourself or others to obtain or assist others in obtaining a U.S. visa or entry ?
Are you currently seeking employment in the United States or have you worked in the United States in the past without obtaining prior permission from the U.S. government ?