US Electronic DV Lottery Form Free Trial (Green Card)

1. Name

Last/Family Name

First Name

No First Name

Middle Name

No Middle Name

2. Gender

Male

Female

3. Birth Date

Month

Day

Year

4. City Where You Were Born

Enter Birth City Only. Do not enter District/County/Province/State.

Birth City

Birth City Unknown

5. Country Where You Were Born

6. Country of Eligibility for the DV Program

Your country of eligibility will normally be the same as your country of birth. Your country of eligibility is NOT related to where you live. If you were born in a country that is not eligible for the DV program, please go to Explanation of Country of Eligibility to see if there is another option available in your case.

Are you claiming eligibility based on the country where you were born?

Yes

No

If not, you must enter the country from which you are claiming eligibility

8. Entrant Photograph

Photographs must be submitted at the time of eDV entry. Photographs that do not comply with all specifications, including but not limited to recency of the photos (must be taken in the last six months), composition of the photos, and unacceptable backgrounds are grounds for disqualification of the entire entry. Any manipulation of photographs that alters the facial characteristics is grounds for disqualification of the entire entry.

Action Needed: Check your photo for compliance!

Ensuring your DV photo meets all specifications is crucial, as mismatches in head height, eye position, or other details can lead to rejection later on. The DV Program site doesn't validate the photo during submission, so even an image of a cat could slip through—but your application won't stand up to scrutiny.

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9. Mailing Address

a. In Care Of (optional)

b. Address Line 1

c. Address Line 2 (optional)

d. City/Town

e. District/County/Province/State

f. Postal Code/Zip code

No postal code / zip code

g. Country

10. Country Where You Live Today

11. Phone Number

(optional)

12. E-mail Address

a. E-mail Address (e.g. johndoe@example.com)

b. Confirm E-mail Address

(NOTE: This email address will be used to provide you with additional information if you are selected.)

13. What is the highest level of education you have achieved, as of today?

You must have a minimum of a high school diploma reflecting the completion of a full course of study (vocation schools or equivalency degrees are not acceptable) or be a skilled worker in an occupation that requires at least two years of training or experience to qualify (visit http://www.onetonline.org/ to see if your occupation qualifies) for a Diversity Visa.

14. What is your current marital status?

Unmarried

Married and my spouse is NOT a U.S.citizen or U.S. Lawful Permanent Resident (LPR)

Married and my spouse IS a U.S.citizen or U.S. Lawful Permanent Resident (LPR)

Divorced

Widowed

Legally Separated

Enter Spouse Information

Legal separation is an arrangement when a couple remain married but live apart, following a court order. If you and your spouse are legally separated, your spouse will not be able to immigrate with you through the Diversity Visa program. You will not be penalized if you choose to enter the name of a spouse from whom you are legally separated.

If you are not legally separated by a court order, you must include your spouse even if you plan to be divorced before you apply for the Diversity Visa. Failure to list your eligible spouse is grounds for disqualification.

If your spouse is a U.S. citizen or Lawful Permanent Resident, do not list him/her in your entry.

15. Number of Children

Children include all biological children, legally adopted children, and stepchildren who are unmarried and under the age of 21 on the date you submit your entry. You must include all eligible children, even if they do not live with you or if they do not intend to apply for a Diversity Visa as your derivative. Failure to list all eligible children is grounds for disqualification. If your child is a U.S. citizen or Lawful Permanent Resident, do not list him/her in your entry.

Part One - Entrant Information

Action Needed: Check your photo for compliance!

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