The form is interactive. More questions can be added based on your answers.

  • Family Name and First Name
    You must enter your names as written in your passport
  • Gender
  • Other names or aliases
    Another name can be the shortened version of your first name, e.g. Elly for Elisabeth
    An alias can be a name used when writing for publication or on a public forum
  • Date of Birth
  • City of Birth
  • Country of Birth
  • Email Address
  • Phone Number
  • Home Address
  • are you a member of the CBP Global Entry Program ?
    if Yes you must enter your PASSID / Membership #
  • First and the Last Name of both your Parents
    if you do not know the name of one of your parents, write “unknown”
  • Information about your Passport:
    the number, your citizenship, issuing country, date of issuance, expiration date
  • have you ever been issued a Passport or Travel ID Card by another country ?
    if Yes you must enter issuing country, document type and number, expiration date
  • are you now a citizen or national of any other countries ?
    if Yes you must add information
  • have you ever been a citizen or national of any other countries ?
    if Yes you must add information
  • Contact and Emergency-Contact in the US or in your home country
  • do you have a current or a previous employer ?
    If Yes you must add name, address, telephone number of employer, as well as your job title
  • Yes/No answers regarding Security:
    • your Health
      physical or mental disorders, drug use, communicable/contagious diseases
    • your Past
      property crimes, harm to another person or authority, illegal drugs-related, terrorist activities, US visa fraud, illegal employment in the US, visa and/or US admission denial, previous US overstay, travel to a country or countries prohibiting ESTA authorization
      An arrest, or a conviction for a minor crime do not need to disqualify a person for ESTA. Realize that once you entered Yes for arrest/conviction, you cannot undo this. You must then apply for a B-1/2 and submit relevant police/judicial records. Processing the application can be lengthy.
  • is your travel to the US because you are in transit to another country ?
    If No you must give:
    US point of contact and address in the US
    This can be a hotel/motel intended for the first night after your arrival (you do NOT need to have a confirmed reservation) or the address of a friend or relative where you are going to stay
  • Information about Social Media accounts
    this Question is optional, you do not need to answer it

Submitting the form means that you understood all questions and answered them truthfully.

If you cannot answer all Security Questions with a No do not submit your ESTA Application but apply for a B-1/2 Visa.