Expedite Travel Services

U.S Online Visitor's Visa Form

Please fill out the form below to the best of your knowledge. Please take your time to fill out the form correctly. You don't need to rush or fill out the form in a hurry. Take your time. If you don't have the information when filling out the form, please wait until you have all information to fill out the form. Please don't fill out the form in bits and pieces. Expedite Travel Services created the form for people applying with us online. Once you have filled out the form and submitted it, the information that you provide on the form will be sent to Expedite Travel Services email. Once we receive the information, we will review it before we begin the process of completing your visa application on the U.S.A Embassy website. If something is missing from the information you filled out, we will reach out to you to provide the missing information. If you are experiencing any challenges interpreting the information, please contact us at 876-909-2433 / 876-560-5040 / 876-553-4282 or WhatsApp 876-560-5040 or 876-553-4282 or send us an email at expeditetravelservice@gmail.com so we can further assist you in properly completing the visa application assessment form.

What is your purpose of travel?

Which country were you born in?

Which country are you currently living in?

Personal Information

Last Name (as stated in your passport)

First Name and Middle Name (as stated in your passport)

Have you used another name in the past, not including a nickname? (For example, if you were married or had a name change.)

Yes No

How many names have you used?

Last Name (not applicable)

First Name (not applicable)

Last Name (not applicable)

First Name (not applicable)

Gender

Marital Status

Date of Birth
/ /

Country of Birth

Parish/City of Birth

Are you a permanent resident of another country?

Yes No

State the country that you are a permanent resident of.

Do you hold another Nationality?

Yes No

State the country you are nationality of.

Do you have a passport for that country?

Yes No

State the Passport Number of that Country.

Do you have a USA social security number?

Yes No

Please enter your social security Number below

Do you have a USA Taxpayer ID Number?

Yes No

Please enter your Tax pay ID Number below

Travel Information

Application Receipt/Petition Number

Date that you plan on travelling to the U.S
/ /

How long will you be staying in the U.S?

Do you know the address where you will stay in the U.S?

Yes No

State the address you will be staying in the U.S below

Are you paying for your trip?

Yes No

Last name of the person paying for your trip

First name of the person paying for your trip

Relationship to you

Telephone of the person paying for your trip

What's the address of the person paying for your trip?

Address Line

City/Province

State

Zip code/Postal code

Country

Are there any other persons travelling with you?

Yes No

How may persons travelling with you?

Last Name of traveler #1

First Name of traveler #1

Relationship to traveler #1

Last Name of traveler #2

First Name of traveler #2

Relationship to traveler #2

Last Name of traveler #3

First Name of traveler #3

Relationship to traveler #3

Last Name of traveler #4

First Name of traveler #4

Relationship to traveler #4

Last Name of traveler #5

First Name of traveler #5

Relationship to traveler #5

Last Name of traveler #6

First Name of traveler #6

Relationship to traveler #6

Have you ever been in the U.S?

Yes No

Do you remember the dates of the last time you traveled to the U.S?

Yes No

How many times have you travelled to the U.S in the past 5 years?

Have you ever been issued a U.S visa?

Yes No

Do you have a copy of the last U.S visa that was issued to you?

Yes No

Date last visa issued
/ /

Date last visa expired
/ /

Visa Number (The visa number is the number in RED in the bottom right hand corner)

Are you applying for the same type of visa?

Yes No

Are you applying in the same country?

Yes No

Have you ever been fingerprinted?

Yes No

Has your visa ever been lost or stolen?

Yes No

Please explain what happened in the event when the U.S. Visa was lost or stolen

Has your U.S visa ever been cancelled or revoked?

Yes No

Please explain what led to your U.S. Visa been cancelled or revoked

Have you ever been refused a U.S visa?

Yes No

Did the visa officer give you a reason as to why they denied you the visa?

Yes No

Please explain why your U.S. Visa was refused

Are you on filing?

Yes No

Who is filing for you?

Current Home Address

Home Address

Mailing Address

City

Work Number

How many contact number do you have?

Please provide your contact numbers below :

What's your main email address?

Please verify your email address

Do have another email address?

Please provide your email address below :

Do you have social media account, such as Facebook Instagram or TikTok?

Yes No

Please select all Social Media accounts that you currently have an account with:
Facebook
Instagram
LinkedIn
TikTok
Snapchat
YouTube
Twitter

Please state your name on Facebook below

Please state your name on Instagram below

Please state your name on LinkedIn below

Please state your name on TikTok below

Please state your name on Snapchat below

Please state your name on YouTube below

Please state your name on Twitter below

Passport Information

Passport Number

Country that Issued Passport

City where passport was Issued

Issue Date
/ /

Expiration Date
/ /

Have you ever lost a passport or had one stolen?

Yes No

Please explain why your passport was lost/stolen

Name and address of person that you're visiting in the U.S

Last Name (If applicable)

First Name (If applicable)

Employer Name

Street Address

City

State

Zip Code

Phone Number

Email Address

What is your purpose of traveling to the U.S?

Purpose

Do you know the Name of the Hotel that you will be staying?

Yes No

Last Name

First Name

Relationship to you

Hotel Name

Last Name (If applicable)

First Name (If applicable)

Name of the place where conference will be held

Street Address

City

State

Zip Code

Phone Number

Email Address

Name of Funeral Home

Address

Contact Number

Date of funeral
/ /

Relationship to the Deceased

Date of the person died
/ /

Family Information

Do you know your father's name?

Yes No

Father's Last Name

Father's First Name

Do you know your father's date of birth?

Yes No

Father's Date of Birth
/ /

Is your father still living?

Yes No

Father's Address

Father's Year of Death

Is your father in the U.S?

Yes No

What's his status in the U.S?

Do you know your mother's name?

Yes No

Mother's Last Name

Mother's First Name

Do you know your mother's date of birth?

Yes No

Mother's Date of Birth
/ /

Is your mother still living?

Yes No

Mother's Address

Mother's Year of Death

Is your mother in the U.S?

Yes No

What's her status in the U.S?

Do you have any sisters, brothers, children or spouse in the U.S?

Yes No

How many immediate relative do you have in the U.S?

Last Name 1

First Name 1

Relationship to you

Status 1

Last Name 2

First Name 2

Relationship to you

Status 2

Last Name 3

First Name 3

Relationship to you

Status 3

Last Name 4

First Name 4

Relationship to you

Status 4

Last Name 5

First Name 5

Relationship to you

Status 5

Last Name 6

First Name 6

Relationship to you

Status 6

Last Name 7

First Name 7

Relationship to you

Status 7

Do you have any other relatives in the U.S?

Yes No

Spouse Information

Spouse's Last Name

Spouse's First Name

Spouse's Date of Birth
/ /

Spouse's Nationality

Spouse's Parish of Birth

Spouse's Address

Former Spouse Information

Former Spouse's Last Name

Former Spouse's First Name

Former Spouse's Date of Birth
/ /

Former Spouse's City of Birth

Former Spouse's Country of Birth

Date of marriage
/ /

Date of marriage ended
/ /

What caused your marriage to end?

Family Information: Fiancé / Fiancée

Fiancé/Fiancée's Surnames

Fiancé/Fiancée First Name and Middle Name

Fiancé/Fiancée's Date of Birth
/ /

Fiancé/Fiancée's Address

Fiancé/Fiancée's Occupation

Family Information: Children

Do you have any children?

Yes No

How many Children do you have?

Child Surname #1

Child First and Middle Name #1

Child Date of Birth #1
/ /

Child Current Address #1

Is this child travelling to the United States with you?

Yes No

Child Surname #2

Child First and Middle Name #2

Child Date of Birth #2
/ /

Child Current Address #2

Is this child travelling to the United States with you?

Yes No

Child Surname #3

Child First and Middle Name #3

Child Date of Birth #3
/ /

Child Current Address #3

Is this child travelling to the United States with you?

Yes No

Child Surname #4

Child First and Middle Name #4

Child Date of Birth #4
/ /

Child Current Address #4

Is this child travelling to the United States with you?

Yes No

Child Surname #5

Child First and Middle Name #5

Child Date of Birth #5
/ /

Child Current Address #5

Is this child travelling to the United States with you?

Yes No

Child Surname #6

Child First and Middle Name #6

Child Date of Birth #6
/ /

Child Current Address #6

Is this child travelling to the United States with you?

Yes No

Occupation

What is Your Employment Status?

Are You Registered Farmer?

Yes No

Address

City

Country

Date when you started
/ /

Monthly Income

Briefly describe what you do as a farmer

Address

City

Country

Date when you started
/ /

Monthly Income

Briefly describe what you do as a self-employed person

Registered Business Name

Date of registration
/ /

Address

City

Country

Monthly Income

Briefly describe what the business is about

Job Title

Company Name

Company Address

City

Company Number

Job Start Date

N.B If you get pay fortnightly, please add both fortnight pay to get your monthly salary.

Monthly Salary Before Tax

Briefly Describe your Duties

Do you have another source of income?

Yes No

Select source of income

Are You Registered Farmer?

Yes No

Address

City

Country

Date when you started
/ /

Monthly Income

Briefly describe what you do as a farmer

Registered Business Name

Date of registration
/ /

Address

City

Country

Monthly Income

Briefly describe what the business is about

Job Title

Company Name

Company Address

City

Company Number

Job Start Date
/ /

N.B If you get pay fortnightly, please add both fortnight pay to get your monthly salary.

Monthly Salary Before Tax

Briefly Describe your Duties

Address

City

Country

Date when you started
/ /

Monthly Income

Briefly describe what you do as a self-employed person

Student

Are you currently attending school?

Yes No

School Address

City

Name of Educational Institution

Date You Started School
/ /

Briefly describe what you are currently studying

Previous Employment

Were you employed with a company within the last 5 years?

Yes No

Do you know the year you started and stop working in your previous employments? If you don't remember put no.

Yes No

How many places had you worked before?

Previous Employer 1

Previous Employer Address 1

Previous Employer Phone Number 1

Previous Job Title 1

When did you start working?

When did you stop working?

Briefly Describe your Duties 1

Previous Employer 2

Previous Employer Address 2

Previous Employer Phone Number 2

Previous Job Title 2

When did you start working?

When did you stop working?

Briefly Describe your Duties 2

School History

Did you attend High School?

Yes No

Do you know the month and year you started and finished high school?

Yes No

How many High School did you attend?

Education History (1)

Name of Institution

Address of Institution

Country

When did you start school?
/

When did you leave school?
/

Education History (2)

Name of Institution

Address of Institution

Country

When did you start school?
/

When did you leave school?
/

Did you attend attend Heart Trust or any Training in Institutions?

Yes No

Do you know the month and year you started and finished training institutions?

Yes No

How many Heart Trust or any Training in Institutions?

Training Institution History (1)

Name of Institution

Address of Institution

Country

Course of Study

When did you start school?
/

When did you leave school?
/

Training Institution History (2)

Name of Institution

Address of Institution

Country

Course of Study

When did you start school?
/

When did you leave school?
/

Did you attend University or College?

Yes No

Do you know the month and year that you started and finished university or college?

Yes No

How many University or College did you attend?

University or College History (1)

Name of Institution

Address of Institution

Country

Course of Study

When did you start school?
/

When did you leave school?
/

University or College History (2)

Name of Institution

Address of Institution

Country

Course of Study

When did you start school?
/

When did you leave school?
/

University or College History (1)

Name of Institution

Address of Institution

Country

Course of Study

When did you start school?
/ /

When did you leave school?
/ /

University or College History (2)

N.B You need to put the date you start and finish school. If you don't remember the date you started and finished school, put the closest date you can remember.

Name of Institution

Address of Institution

Country

Course of Study

When did you start school?
/ /

When did you leave school?
/ /

Additional Information

Have you travelled to any country or regions within the last five years?

Yes No

Select the number of countries you have visited in the last five years

Country/Region (1)

Country/Region (2)

Country/Region (3)

Country/Region (4)

Country/Region (5)

Country/Region (6)

Country/Region (7)

Country/Region (8)

Country/Region (9)

Country/Region (10)

Do you have any training in using firearm?

Yes No

Please explain what type of training you have in using firearms?

Have you ever been arrested before?

Yes No

Why were you arrested?

Student/Exchange Visa Information

List at least two contacts in your country of residence who can verify the information that you have provided on this form. Do not list immediate family members or other relatives. Postal office box numbers are unacceptable.

Contact Person: #1

Last Name

First Name

Address

Telephone

Email

Contact Person: #2

Last Name

First Name

Address

Telephone

Email

SEVIS Information

SEVIS ID

Program Number

Student/Exchange Visa Information

List at least two contacts in your country of residence who can verify the information that you have provided on this form. Do not list immediate family members or other relatives. Postal office box numbers are unacceptable.

Contact Person: #1

Last Name

First Name

Address

Telephone

Email

Contact Person: #2

Last Name

First Name

Address

Telephone

Email

SEVIS Information

SEVIS ID

School Name

Course of Study

School Address Address Line 1

Address Line 2

City

State

Zip Code

Temporary Work Information

Application Receipt/Petition Number

Name of Company who Filed Petition

Name of employer

Employer address where you'll work Address Line 1

Address Line 2

City

State

Zip Code

Employee Phone Number

Monthly Income in USD

Email address

Confirm Email address

For further enquiries contact us at 876-553-4282 / 876-909-2433 / 876-560-5040 or WhatsApp 876-560-5040 or 876-553-4282 or send us an email at expeditetravelservice@gmail.com we will respond to you promptly.