New Application – ESTA Application

DO NOT USE SPECIAL CHARACTERS WHEN FILLING OUT THIS APPLICATION. Ü should be UE. Ö should be OE. ß should be SS. Ä should be AE.

APPLICANT / PASSPORT INFORMATION

Enter all information in the same format as on your passport.

Family Name*

First Name*

Gender*

Male
Female

Are you known by any other names or aliases?*

Yes
No

Name or Alias

Family Name*

First Name*

Date of Birth

Day*

Month*

Year*

City of Birth*

Country of Birth*

Passport Number*

Country of Citizenship*

National Identification Number*

Issuing Country*

Personal Identification Number*

Issuance Date

Day*

Month*

Year*

Expiration Date

Day*

Month*

Year*

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

If you have never been issued any one of these documents by any other country answer "No" to this question. If you have been issued one of these documents from another country, but you do not remember the passport number or national identification card number and the year of expiration answer "UNKNOWN" in the passport number field and four zeros "0000" in the year of expiration field.

Yes
No

Issuing Country*

Document Type*

Document Number*

Expiration Year*

OTHER CITIZENSHIP/NATIONALITY

Are you now, a citizen or national of any other country?*

Yes
No

Country of Citizenship / Nationality*

How did you acquire citizenship / nationality from this country?*

Other*

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

Yes
No

Country of Citizenship / Nationality*

GE MEMBERSHIP

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

Yes
No

PASSID / Membership Number*

PARENTS

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.

Family Name*

First Name*

Family Name*

First Name*

YOUR CONTACT INFORMATION

Address Line 1*

Address Line 2

Apartment Number

City*

State/Province/Region*

Country*

Telephone Type*

Country Code

Phone*

E-mail Address*

SOCIAL MEDIA (OPTIONAL)

Please enter information associated with your online presence.

Provider / Platform

Other Platform / Provider*

Social Media Identifier*

List the username, handle, screen-name, or other identifier associated with your social media profile.

EMPLOYMENT INFORMATION

Do you have a current or previous employer?*

Yes
No

Employer Name*

Address Line 1*

Address Line 2

City*

State/Province/Region*

Country*

APPLICANT / PASSPORT INFORMATION

Name or Alias

Date of Birth

Issuance Date

Expiration Date

OTHER CITIZENSHIP/NATIONALITY

GE MEMBERSHIP

PARENTS

YOUR CONTACT INFORMATION

SOCIAL MEDIA (OPTIONAL)

EMPLOYMENT INFORMATION

U.S. POINT OF CONTACT INFORMATION

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

ELIGIBILITY QUESTIONS

A fee of USD79 is charged per application, which includes a fee charged by the US government. By clicking 'Pay and confirm' you accept our Terms and Conditions and Privacy Policy.