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?*
NO
YES
Have you ever violated any law related to possessing, using, or distributing illegal drugs?*
NO
YES
Do you seek to engage in or have you ever engaged in terrorist activities, espionage, sabotage, or genocide? *
NO
YES
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?*
NO
YES
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?*
NO
YES
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you applied for with your current or previous passport, or have you ever been refused admission to the United States or withdrawn your application for admission at a U.S. port of entry?*
NO
YES
Have you ever stayed in the United States longer than the admission period granted to you by the U.S. government?*
NO
YES
Have you traveled to, or been present in Iraq, Syria, Iran, or Sudan on or after March 1, 2011? *
NO
YES
Travel Information #1
Country*
Please Select
IRAN(IRN)
IRAQ(IRQ)
SUDAN(SDN)
SYRIA(SYR)
From*
Month
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1920
To*
Month
1
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2018
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1998
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1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Primary Reason*
Please Select
To travel as a tourist (vacation)
For personal travel or a family visit (including emergencies)
For commercial / business purposes
To carry out official duties as a full-time employee of the government of a Visa Waiver Program country
To perform military service in the armed forces of a Visa Waiver Program country
To conduct work as a journalist
To engage in humanitarian assistance on behalf of a humanitarian or international non-governmental organization
To carry out official duties on behalf of an international organization or regional (multilateral or inter-governmental) organization
To carry out official duties on behalf of a sub-national government or body of a VWP country
To attend an academic institution
To participate in a professional exchange or conference
To participate in a cultural exchange program
Other
Remove travel
Add another travel
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. *
I consent to the processing of the personal information provided in this application. *
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