Formulario ESTA

The following information is required of every nonimmigrant visitor not in possession of a visitor's visa who is a national of one of the eligible countries. Please enter all information requested. Each member of your traveling party must complete a separate application.

Please provide all responses in English. Mandatory fields are indicated by a red asterisk *

Application Submittal

Please review all information for accuracy before submitting your application. If something is inaccurate, select the Previous button and edit the application with the correct information.

Applicant Information

Family Name

First (Given) Name

Are you known by any other names or aliases?

Birth Date Day: Month: Year:

City of Birth

Country of Birth

Sex

Parents

	Family Name	First (Given) Name

Passport Information

Passport Number

Issuing Country

Personal Identification Number

Passport Issuance Date Day: Month: Year:

Passport Expiration Date Day: Month: Year:

Country of Citizenship

National Identification Number

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?

Are you a member of the CBP Global Entry Program?

Contact Information

E-mail Address

Telephone Number

	Type	Country Code	Telephone Number

Home Address

	Address Line 1	Apartment Number

	Address Line 2	City

	State/Province/Region	Country

Emergency Contact Information In or Out of the United States

Emergency Contact

	Family Name	First (Given) Name

Telephone Number

	Country Code	Number

E-mail Address

Travel Information

Is your travel to the US occurring in transit to another country?

Employment Information

Do you have a current or previous employer?

Do any of the following apply to you? (Answer Yes or No)

1) 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, Diphtheria, Tuberculosis, infectious, Plague, Smallpox, Yellow Fever, Viral Hemorrhagic Fevers, including Ebola, Lassa, Marburg, Crimean-Congo, Severe acute respiratory illnesses capable of transmission to other persons and likely to cause mortality.
2) 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?
3) Have you ever violated any law related to possessing, using, or distributing illegal drugs?
4) Do you seek to engage in or have you ever engaged in terrorist activities, espionage, sabotage, or genocide?
5) 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?
6) 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?
7) 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? If yes: If yes: when where
8) Have you ever stayed in the United States longer than the admission period granted to you by the U.S. government?

Please review all information for accuracy before submitting your application. If something is inaccurate, select the Previous button and edit the application with the correct information.

Waiver of Rights: I have read and understand that I hereby waive for the duration of my travel authorization obtained via ESTA any rights to review or appeal of a U.S. Customs and Border Protection Officer's determination as to my admissibility, or to contest, other than on the basis of an application for asylum, any removal action arising from an application for admission under the Visa Waiver Program. In addition to the above waiver, as a condition of each admission into the United States under the Visa Waiver Program, I agree that the submission of biometric identifiers (including fingerprints and photographs) during processing upon arrival in the United States shall reaffirm my waiver of any rights to review or appeal of a U.S. Customs and Border Protection Officer's determination as to my admissibility, or to contest, other than on the basis of an application for asylum, any removal action arising from an application for admission under the Visa Waiver Program.

Certification: I, the applicant, hereby certify that I have read, or have had read to me, all the questions and statements on this application and understand all the questions and statements on this application. The answers and information furnished in this application are true and correct to the best of my knowledge and belief.

Issuing Country	Document Type

Document Number	Expiration Year

	USA +1(866)961-3577
	Spain +34(902)848240
	United Kingdom +44(870)8200209
	Chile +(56)229382609

ESTA Application

Applicant Information

Passport Information

Other Citizenship/Nationality

Contact Information

Social Media

GE MEMBERSHIP

Parents

Employment Information

Travel Information

US Point of Contact Information

Emergency Contact Information In or Out of the United States

Do any of the following apply to you? (Answer Yes or No)

Application Submittal

Applicant Information

Passport Information

Contact Information

Emergency Contact Information In or Out of the United States

Travel Information

US Point of Contact Information

Employment Information

Do any of the following apply to you? (Answer Yes or No)

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