US visa questionnaire

82 questions, 9 of them required · about 29 min. Answers are saved in this browser, so you can continue later.

We translate and check your answers and agree the final form with you before submission. Not sure about an answer? Skip it — we will clarify it together.

1Contact details6 questions

Full name *

Contact phone (mobile) *

Email *

Other phone numbers over the last 5 years (if any)

Other email addresses (if any)

Links to social media (for example, Instagram, LinkedIn, VK)

2About you6 questions

Have you ever changed your last name, first name, or patronymic?

It is important to indicate any change, not only a last name change after marriage. Write your previous full name and the year when it was changed. If you have not changed it, put a dash.

Place of birth (city, village, settlement, other) *

City of international passport issuance

Home address (actual) *

Home address (registered address)

4Family11 questions

Full name of spouse (all details are required even if you are divorced or living in a civil marriage)

Spouse's date of birth

Spouse's place of birth, country and city

Spouse's citizenship

If you are divorced, you must indicate the date of marriage

And also the date of divorce

If you are a widower (widow), you must indicate the date of death of your spouse

Father's full name *

Mother's full name *

Father's date of birth

Mother's date of birth

5Trip to the USA6 questions

What city are you flying to? (If known)

Who are you planning to fly to the United States with (full name, relationship to you)

Planned address of residence in the United States and contact person (organization) (if applicable)

Trip start date (if known)

Trip end date (if known)

Number of days of stay

6Visa history9 questions

Have you ever lost your international passport or has it been stolen from you (details)

Have you previously received U.S. visas? If yes, indicate the visa type, number, date and place of issue of only the most recent visa

Do you have a Social Security card? (This item is optional). If yes, indicate its number

List your last 5 visits to the United States (exact dates of entry to the United States, duration of stay, e.g., 1 day or 3 weeks, approximate is acceptable)

Have you ever been denied a U.S. visa? If yes, indicate the approximate date and presumed reason

Do you have any relatives in the United States? If yes, full name, relationship, status in the United States

Do you have or have you ever had citizenship/residence permit of another country? If yes, indicate the country and number of the citizenship/residence permit

List all countries you have visited in the last 5 years

Have you ever had a criminal record? If yes, details

7Previous places of work17 questions

Indicate your two most recent places of employment in the last 5 years (excluding your current one)

(write below)

Employer name 1

Work phone 1

Employer address 1

Job title 1

Full name of supervisor 1

Briefly describe your duties

Job 1 start date

Job 1 end date

Employer name 2

Work phone 2

Employer address 2

Job title 2

Last name, first name of supervisor 2

Briefly describe your duties

Job 2 start date

Job 2 end date

8Education and military service13 questions

Which languages (other than Russian) do you speak

Have you served in the military?

List all educational institutions, except general education school, that you graduated from or attended

(write below)

Educational institution name 1

Field of study 1

Educational institution address 1

Study start date 1

Study end date 1

Educational institution name 2

Field of study 2

Educational institution address 2

Study start date 2

Study end date 2

9Documents and photo3 questions

1st page of international passport (photo)Choose photos or PDFJPG, PNG, HEIC or PDF · up to 6 files per questionnaire, 15 MB in total

Photo of the latest US visa (if any)

Passport spread with an old US visa. If you have never had a US visa, skip it.

Choose photos or PDFJPG, PNG, HEIC or PDF · up to 6 files per questionnaire, 15 MB in total

Portrait photo

Color photo of the face, full-face, on a light plain background, without glasses or headwear. You can take it with a phone in daylight. Photo requirements

Choose photos or PDFJPG, PNG, HEIC or PDF · up to 6 files per questionnaire, 15 MB in total

10Additional2 questions

If you did not have enough space for education information or have additions for any other reason, please enter them in this line

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