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Official government Green Card (Diversity Visa) Lottery program.
       
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USA GREEN CARD LOTTERY
APPLICATION FORM

Dear applicant
Next STEP is APPLICATION PAYMENT


For what you pay? Please, check out "Our Service".


Last Name/Surname (Family name, like in your passport)

First name/Name (like in your passport)

Middle Name

month of birth


day of birth

year of birth

Gender

City where you were born

Country where you were born

Mailing address (your home address )

Country where you live today

Phone number

e-mail address. IMPORTANT:
(you MUST enter a VALID e-mail address)

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

What is your current marital status


Retype your e-mail address

Number of children (Only unmarried and under the age of 21)

SPOUSE (Wife or Husband) INFORMATION (if you are married):

Last Name (Family name)

First name

Middle Name

month of birth


day of birth

year of birth

Gender

City where spouse was born

Country where spouse was born

Mailing address

Country where spouse lives today

Phone number (optional)

e-mail address. IMPORTANT:
(you MUST enter a VALID e-mail address)

What is the highest level of education that spouse achieved, as of today?
 

Information of child #1 (under 21 years old):

Last name


First name


Middle name


month of birth


day of birth

year of birth


Place of birth (city, country)


Gender

Information of child #2 (under 21 years old):
Last name


First name


Middle name

month of birth


day of birth

year of birth


Place of birth (city, country)


Gender

Information of child #3 (under 21 years old):
Last name


First name


Middle name

month of birth


day of birth

year of birth


Place of birth (city, country)


Gender

Information of child #4*** (under 21 years old):

Last name


First name


Middle name


month of birth


day of birth

year of birth


Place of birth (city, country)


Gender


After submitting your application form you will receive an e-mail about your application process. If you can't see this e-mail in your "Inbox" folder, please, check out your "Junk/Spam" folder too.

*** if you have more than four children, please, e-mail us their information:

dv@win-usa-green-card.com

www.win-usa-green-card.com

 

 
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win-usa-green-card is a non-government organization that provides payable consultancy service for people who want
to get professional help to participate in and not to be disqualified from the Official U.S. Green Card Lottery program.
The official site accepts applications for free but without help, consultancy or support.

Copyright @2011-2014 www.win-usa-green-card.com All rights reserved.

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