USA VISA
Name In English and Arabic ( as in passport) :
Other Names Used
Gender
Marital Status
Date of Birth
Place of Birth
Country/Region of Origin (Nationality)
Do you hold or have you held any nationality other than the one indicated above on nationality?
Are you a permanent resident of a country/region other than your country/region of origin (nationality) above?
Do you have U.S. Social Security Number or taxpayer ID no. ?
Home Address:
Primary Phone Numbe
Secondary Phone Number
Work Phone Number
Do you have any additional phone numbers?
Email Address:
Do you have any additional email addresses?
Do you have a social media presence?
Have you ever lost a passport or had one stolen
Purpose of Travel
Have you made specific travel plans?
Dates of Travel and length of Stay
Address where you will stay in the U.S.:
Person/Entity Paying for Your Trip
Are there other persons traveling with you?
Are you traveling as part of a group or organization?
If Yes, Persons Traveling with You, relationship to you ?
Have you ever been in the U.S.?
Have you ever been issued a U.S. visa?
Have you ever been refused a U.S. Visa, or been refused admission to the United States, or withdrawn your application for admission at the port of entry?
If yes, Explain
Has anyone ever filed an immigrant petition on your behalf with the United States Citizenship and Immigration Services?
Contact Person or organization Name in the U.S.
Relationship to you.
U.S. Contact Address, Phone No. and Email
Father's full name , date of Birth, Is he in the US ?
Mother's full name , date of Birth, Is she in the US ?
Do you have any immediate relatives, not including parents in the U.S.?
Do you have any other relatives in the United States?
Primary Occupation:,, employer/school , address , phone No.
Monthly Salary in Local Currency (if employed):
Briefly Describe your Duties:
Were you previously employed?
If yes,Employer Name, address , phone No. your Job Title
Supervisor's Full Name, Dates Of Employment From----- To----
Briefly describe your duties:
Have you attended any educational institutions at a secondary level or above?
Name of Institution , address, start date From---- To---, course of study ?
Name of other Institution , address, start date From---- To---, course of study ?
Do you belong to a clan or tribe?( هل تنتمي الى عشيرة او قبيلة )
Provide a List of Languages You Speak:
Have you traveled to any countries/regions within the last five years?
Have you belonged to, contributed to, or worked for any professional, social, or charitable organization?
Do you have any specialized skills or training, such as firearms, explosives, nuclear, biological, or chemical experience?
Have you ever served in the military?
Have you ever served in, been a member of, or been involved with a paramilitary unit, vigilante unit, rebel group, guerrilla group, or insurgent organization? (هل سبق لك أن خدمت ، أو كنت عضوًا ، أو شاركت في وحدة شبه عسكرية ، أو وحدة أهلية ، أو مجموعة متمردة ، أو مجموعة حرب عصابات ، أو منظمة متمردة؟)
هل لديك اي امراض معدية ؟او اي اي مشاكل صحية او نفسية ممكن ان تؤثر عليك او على آخرين ؟
هل سبق و ان تتعاطيت المخدرات او كنت مدمن عليها ؟
هل سبق و ان تمت ادانتك لارتكاب اي جريمة او كسر للقوانين ؟ او غسيل اموال ؟
هل سبق و ان شاركت بعملية الاتجار بالبشر او لديك اقارب شاركوا فيها بأمريكا او غيرها من الدول ؟ او قمت بالتغطية غلى شخص قام بجريمة ؟
هل تسعى للانخراط بأي عملية تجسس او تخريب او انتهاك القوانين او المشاركة بعمليات الارهاب او تمثل منظمات ارهابية , او لديك اقارب هكذا ؟
هل تنتمي الى حزب شيوعي او اي احزاب اخرى ؟
هل سبق و ان كشفت عن معلومات تجارية سرية عن شركة في امريكا ؟
هل سبق و ان سعيت للحصول او مساعدة آخرين في الحصول على تأشيرة او الهجرة بطريقة غير قانونية ؟ و هل سبق ان تم ابعادك او ترحيلة من بلد ؟
هل سبق و ان تخليت عن الجنسية الأمريكية بغرض تجنب الضرائب ؟
الموقع الذي ستقدم فيه طلبك ؟
Send
Email Address
Password
Log In
Lost your password?
|
Register
