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Please Note: application-travel.us.com is a private service, and not associated with the US Government.

U.S. ESTA AUTHORIZATION FORM

Welcome, you are entitled to a Electronic System for Travel Authorization to United States.

If you apply for ESTA, make sure:

  • You’re visiting for a maximum of 90 days
  • You’re traveling exclusively for business, transit or pleasure

Need to stay longer than 90 days? Apply for B1/B2 Visa (Embassy Visit is Required)

APPLICANT / PASSPORT INFORMATION

Refer to your passport and enter all information in the same format.

OTHER CITIZENSHIP/NATIONALITY

GE MEMBERSHIP

PARENTS

Please list your parents names in the boxes to the right. All applicants are required to fill out this section.

YOUR CONTACT INFORMATION

Please enter your contact information below.

EMPLOYMENT INFORMATION

UNKNOWN

TRAVEL INFORMATION

U.S. POINT OF CONTACT INFORMATION

UNKNOWN

ADDRESS WHILE IN THE U.S.

EMERGENCY CONTACT INFORMATION IN OR OUT OF THE U.S.

 

ELIGIBILITY QUESTIONS

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you applied for with your current or previous passport, or have you ever been refused admission to the United States or withdrawn your application for admission at a U.S. port of entry?


8) Have you ever stayed in the United States longer than the admission period granted to you by the U.S. government?

9) Have you traveled to, or been present in Iraq, Syria, Iran, Sudan, Libya, Somalia or Yemen on or after March 1, 2011?

APPLICANT'S DECLARATION

I declare that the information I have provided in this application is truthful, complete and accurate to the best of my knowledge.

I understand that an approved travel authorization is NOT a visa. It does not meet the legal or regulatory requirements to serve in lieu of a United States visa when a visa is required under United States law. Individuals who possess a valid visa will still be able to travel to the United States on that visa for the purpose for which it was issued. Individuals traveling on valid visas are not required to apply for a travel authorization.

I have read and understood the terms of the Visa Waiver Program. I understand that If my Electronic Travel Authorization is approved, this approval establishes that I am eligible to travel to the United States under the Visa Waiver Program but does not guarantee that I am admissible to the United States. Upon arrival in the United States, I will be inspected by a Customs and Border Protection officer at a port of entry who may determine that I am inadmissible under the Visa Waiver Program or for any reason under United States law.

I understand that attempting to obtain an Electronic System for Travel Authorization (ESTA) under the US Visa Waiver Program by the willful misrepresentation of a material fact, or fraud, is an offense under INA 217, 8 U.S.C. 1187 and the CFR Title 8, Subchapter B, Part 217 and may result in the permanent refusal of a Travel Authorization, or adjudicated inadmissibility for entry into the USA as well as removal from the United States and its territories after entry has been granted based on such willful misrepresentations.

Third-Party Authorization

I understand that I am applying via GovAssist, LLC; a third-party that is not affiliated with the United States’ government, that the third-party cannot guarantee application approval, that the third-Party service is offered to help expedite the process as experts and that I have the option to apply directly with the pertinent government websites. I also understand that my purchase includes a processing and service fee to GovAssist, which includes the USD $14.00 non-refundable government fee, required by the Travel Promotion Act of 2009 (Section 9 of the United States Capitol Police Administrative Technical Corrections Act of 2009, Pub. L. No. 111-145).

I confirm and authorize GovAssist LLC to assist me, by using their processing service in completing and reviewing my application. I understand and acknowledge that I have not been offered legal advice and that this company or its agents and affiliates have never claimed to be qualified to offer legal advice under any circumstance. I also confirm that I am submitting my application and signing it myself. By obtaining services from the GovAssist website I have agreed to the following: Terms & Conditions | Refund Policy | Privacy Policy | Disclaimer

Applicant's Signature

To sign, please enter your full name exactly as it appears on your passport