Fill out the Electronic Visa Application (ESTA)

Please enter the name, first name (s) and passport number exactly as they appear on your passport information page.

Enter your Family (last) name as it appears in your passport in the Last name field. Last name is required to complete the application.
Enter your first name here as it appears in your passport in the First Name field. The first name is required to complete the application.
Enter your middle name here, as it appears in your passport in the First name field. First name 2 is optional to continue the request.
Please indicate your gender. Required to complete the application.
Enter the email address at which you can be contacted. The email address is required to complete the request. If you don't have an e-mail address, you may provide the e-mail address of a third party (for example, a family member, friend or colleague).
Confirm here the email address you entered in the first Email field
Indicate your date of birth. Date of birth is required to complete the request.
Please confirm your date of birth
Indicate here the town, chief town, village or hamlet where you were born. The city, town, village or hamlet where you were born is required to complete the request. If you don't know the city where you were born, type UNKNOWN.
Choose the country where you were born. Country of birth is required to complete the request.

Address

In this Line 1 Address field, enter your home address number and street. Don't include city and state in this field. Line 1 address is required to complete the application.
In this field Address line 2, enter the floor, building or other additional information related to your address. Don't include city and state in this field. The address line 2 is optional to be able to continue the request.
Enter the postal code of your city
Indicate here the city, the chief town, the village or the hamlet. The city, town, village or hamlet is required to complete the application.
Indicate your country of residence. The country is required to complete the application.
At least one telephone number is required to complete the application. If you don't have a telephone number, you can give an alternative telephone number of a third party belonging to a contact point (for example a family member, friend or colleague). The telephone number is required to complete the application.

Passport information

Enter your passport number as it appears on your passport. The passport number may contain numbers and/or letters (9 maximum). Make a clear distinction between the number 0 and the letter O. The passport number is required to complete the application.
Enter your passport number as it appears on your passport. The passport number may contain numbers and/or letters (9 maximum). Make a clear distinction between the number 0 and the letter O. The passport number is required to complete the application.
Indicate the date your passport was issued, as it appears in your passport in the Date of Issue field. The date of issue of the passport is required to complete the application.
Indicate the expiry date of your passport, as it appears in your passport in the Expiry Date field. The expiry date of the passport is required to complete the application.
Indicate the country of your nationality as it appears in your passport. The country that issued the passport must complete the application.
Choose the country of which you are a national, as it appears in your passport. The country of which you are a national is required to complete the application.
Please enter your national ID number

Eligibility Questions

Please check your answers, as Authorization may be denied if you answer 'Yes' to any of the following questions
When
Where
Country
please indicate the start date of your visit to this country
please indicate the end date of your visit to this country
Motif du voyage
Please identify the business entity on behalf of which you traveled
Please identify the business entity on behalf of which you traveled
Please identify the business entity on behalf of which you traveled
Does your organization have consultative status with the United Nations
What was your official position
What was your official position
What was your official position
Have you ever received an I-Authorization from a US. Consulate?
Please provide contact information for the entity identified
Please provide contact information for the entity identified
Iranian Business Authorization Number
List all companies in Iran with which you had business
Please provide your Authorization Number related to your humanitarian trip
If your organization has been a recipient of U.S. government funding for humanitarian, please provide the recent grant number.
Please provide information about the work you were doing in this country
For example, international governmental organizations (IGOs) include the United Nations, NATO, the IMF, and the World Bank. International non-governmental organizations (INGOs) like Amnesty International and the International Red Cross

Aliases / Employer

Family Name
First (Given) Name
Kindly indicate your employer name
Kindly indicate the employer address
Employer City
Employer country

Parents

Parent 1: Last name
Parent 1: First name
Parent 2: Last name
Parent 2: First name

Other Citizenship

Country of Citizenship
Explanation
NULL
Document Number
Document Type
Issued Country
Expiration Date
Land der Staatsangehörigkeit
From
To

Emergency Contact

please indicate a contact name in case of emergency
Contact's first name
Contact's phone
Contact's Email

Travel information

Indicate your intended date of travel (Optional information)
A U.S. point of contact may be a friend, relative, or business associate. If you do not have a U.S. point of contact, please enter the name, address and telephone number of the location where you will be staying (e.g. a hotel name). You may also enter UNKNOWN.
In the Address Line 1 field, enter the number and street of your U.S. Point of Contact's address. Do not include the city and state in this field. Address line 1 is required to complete the application. If you do not know the address of the employer you listed you may enter UNKNOWN.
In the Address Line 2 field, enter floor, building, or other, as appropriate. Do not include the city and state in this field. Address line 2 is optional to complete the application.
In the Apartment Number field, enter apartment, suite, unit, or other, as appropriate. Do not include the city and state in this field. Apartment number is optional to complete the application.
In the City field, enter the city. The city is required to complete the application. You may also enter UNKNOWN.
In the State field, choose the state. The state is required to complete the application. You may also select UNKNOWN.
Enter your U.S. point of contact telephone number. The number is required to complete the application. If you do not have a point of contact telephone number you may enter zeros.
In the Address Line 1 field, enter the number and street of the location where you will stay while in the United States. Do not include the city and state in this field. Address line 1 is optional to complete the application.
In the Address Line 2 field, enter floor, building, or other, as appropriate. Do not include the city and state in this field. Address line 2 is optional to complete the application.
In the Apartment Number field, enter apartment, suite, unit, or other, as appropriate. Do not include the city and state in this field. Apartment number is optional to complete the application.
In the City field, enter the city. The city is optional to complete the application.
In the State field, choose the state. The state is optional to complete the application.

General information

Specific information

After completing the form and validating your payment, all your details will be checked and validated. Once your application is accepted, you will quickly receive your Electronic Travel Authorization by return email allowing you to visit the United States.