Please Note: TravelAssist is a private service, and not associated with the US Government.
Helping you travel to the United States from anywhere in the world.

step 1

Basic information

step 2

Travel information

step 3

FINAL DETAILS

U.S. VISA AUTHORIZATION FORM

Welcome, you are entitled to a United States B1/B2/C1 Visa.

If you apply, make sure:

  • You’re visiting for a maximum of 6 months
  • You’re traveling exclusively for business, transit or pleasure

Please Note: Embassy Visit is Required for Interview

B1-B2 Visa

Passport Information

 
 
 
 
 
 
 
Yes
No
 
 
 
 

Basic information of the applicant

 
If you have more than one name or last name, please add it here
 
 
 
Male
Female
 
 
 
 
 
 
 
Yes
No
 
 
Yes
No
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes
No
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

INDICATE THE FOLLOWING INFORMATION ABOUT YOUR PARENTS

Yes
No
 
Yes
No
 
 
Yes
No
 
Yes
No
 
 
Yes
No
 
 
 
 
 
 
 
Yes
No
 
 
 

CONTACT INFORMATION - ADDRESS OF THE PERSON REQUESTING THE APPLICATION

 
 
 
 
 
 
 
 
 
 
 
Yes
No
 
 
 
 
 
 
 
 
 
 

ADDITIONAL NATIONALITIES

Yes
No
 
 
 
 
Yes
No
 
 

PAST TRAVEL & APPLICATIONS

Yes
No
 
 
 
 
Yes
No
 
 
 
 
 
Yes
No
 
 
 
 
 
 
 
 
Yes
No
 
Yes
No
 
Yes
No
 
Yes
No
 
 
 
 
Yes
No
 
 
 
 
 
Yes
No
 
 
Yes
No
 
 
Yes
No
 
 
Yes
No
 
 
 
 

UPCOMING TRIP TO THE U.S.

 
Please try to provide accurate information of your stay and note this has to be an address where you can actually be contacted. If you do not know a person in the US, you may enter the name of the hotel, company, or organization you plan to visit during your trip, or the University campus address.
 
 
 
 
*
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Your U.S. Point of Contact can be any individual in the U.S. who knows you and can verify, if necessary, your identity. If you do not personally know anyone in the U.S., you may enter the name of the store, company, or organization you plan to visit during your trip.
Contact Person
Organization
 
Hotel
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes
No
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes
No
 
 
 
Yes
No
 
 
 
 
 
 
 
Yes
No
 

Provide a complete itinerary for your trip to the US

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

ADDITIONAL QUESTION

 
 


Yes
No
 
 
 
 
 
 
 
 
 
 
 
Yes
No
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes
No
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes
No