ESTA Direct (Step 1 of 3)

1

Personal & Travel Information

2

Check & Confirm Your Details

3

Choose Your Payment Method & Pay

Applicant Information

Firstname / Lastname: *

Gender: *

Other Names/Aliases: *

Birth Date / City of Birth: *

Country of Birth: *

Mother's Name / Mother's Last Name: *

Father's Name / Father's Last Name: *

Contact Information

E-mail Address: *

Telephone Type

Telephone Number: *

Address Line / Apartment Number: *

Post Code / City: *

Country / Region: *

Employment Information

Do you have a current or previous employer: *

Social Media

Do you want to provide information associated with your online presence: *

Emergency Contact Information In or Out of the United States

Emergency Contact: *

Telephone Number: *

E-mail Address: *

Travel Information

Is your travel to the US occurring in transit to another country: *

Passport Information

Country of Citizenship: *

Passport Issuing Country: *

Passport Number: *

Passport Issuance Date: *

Passport Expiration Date: *

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

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

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

GE Membership

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

Do any of the following apply to you?

Do you have a physical or mental disorder; or are you a drug abuser or addict; or do you currently have any of the following diseases (communicable diseases are specified pursuant to section 361(b) of the Public Health Service Act): *
  • Cholera
  • Diphtherie
  • Tuberculosis, infectious
  • Plague
  • Smallpox
  • Yellow Fever
  • Viral Hemorrhagic Fevers, including Ebola, Lassa, Marburg virus disease, Crimean-Congo
  • Severe acute respiratory illnesses capable of transmission to other persons and likely to cause mortality

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: *

Have you ever violated any law related to possessing, using, or distributing illegal drugs: *

Do you seek to engage in or have you ever engaged in terrorist activities, espionage, sabotage, or genocide: *

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: *

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: *

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: *

Have you ever stayed in the United States longer than the admission period granted to you by the U.S. government: *

Have you traveled to, or been present in Iraq, Syria, Iran, Sudan, Libya, Somalia or Yemen on or after March 1, 2011: *