Online visa questionnaire

You can download Initial Questionnaire or fill the blank below:





Personal Information

Surname (Last Name)

Given Name(s)

Name in Native Alphabet

Birth Date (day / month / year)

Birthplace (city, province, or state, country)

Current Nationalities
1st

2nd

Social Security No.

US DL/ID#

Contact Information

Address 1

Address 2

City

State/Province

Zip Code

Country

Phone Number

Fax Number

Mobile

Email

U.S. Residential Address

Do you have a U.S. address?
 Yes No

Passport/Visa Information

Passport/ID#

Expiration Date (day / month / year)

Prior U.S. visa application(s)?
 Yes No

Currently valid US visa?
 Yes No

Multiple Entry?
 Yes No

Has your U.S. visa ever been cancelled?
 Yes No

Have you ever overstayed the duration of a visa status?
 Yes No

Have you ever been refused entry into the U.S.?
 Yes No

Preferred Consulate for Processing Abroad
City

Country

Employment Information

Current Employer Information

Business Name

Start Date (day / month / year)

Your Title

Business Address
Address 1

Address 2

Business City

Business State

Business Zip Code

Phone Number

Fax Number

Mobile

Email

Current U.S. Employment Offer?
 Yes No

Educational Experience

Total years as student

University

Degree

Specialization

Graduation Year

University #2

Degree #2

Specialization #2

Graduation Year #2

Inadmissibility Information

Have you ever been arrested or convicted anywhere in the world?
 Yes No

Have you ever lied or misrepresented yourself to get any U.S. visa or immigration benefit?
 Yes No

Family Information

Marital Status
 Single Significant Other/Domestic Partner Legally Married Separated Divorced Widowed

Children
 Yes No

Number of children

Family members with US citizenship (USC) or permanent residence (LPR)?
 Yes No

Has any parent or grandparent ever lived in the USA
 Yes No

Misc

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