Please complete all mandatory fields (marked with red asterisk *)
If you do not know the answer to following questions: City of Birth, Parents, Emergency Contact, Emergency Contact Telephone Number, Emergency Contact E-mail Address, US Point of Contact, US Point of Contact Address, US Point of Contact Telephone Number, Employer Address. Please type UNKNOWN in these fields.
Personal Details
Please ensure you upload the entire passport biographic page of the traveler applying for ESTA authorization. You can do a photo of your passport page or a scan. You can upload .jpg, .jpeg, .png, .pdf files.
Passport Information
Other Citizenship / Nationality
Country:*
How did you acquire citizenship / nationality from this country?*
Country:*
GE Membership
Contact Details
Emergency Contact Details In or Out of the United States
Travel Information
Address While In The United States (Optional)
Employment Information
Additional Employment Information (Optional)
Do any of the following apply to you?