Green Card Lottery Entry Data

LAST NAME (Family Name/Surname)     
First Name     
Middle Name     
DATE OF BIRTH     Day      Month      Year
                                   		  
PLACE OF BIRTH
City/Town (Required)     
District/County/ Province     
Country (Required)     

NATIVE COUNTRY IF DIFFERENT FROM COUNTRY OF BIRTH   

 
 
COUNTRY WHERE YOU LIVE TODAY (Required)  
 
HIGHEST LEVEL OF EDUCATION YOU HAVE ACHIEVED, as of today (Required)  
 
PLEASE NOTE: If you selected (1) Primary school only or (2) High school, no degree or (4) Vocational school, from the above list you must then meet the work experience requirements in order to enter the Lottery. Information about work experience requirements and a list of acceptable jobs is available on our web page www.americangreencard.com/howenter.htm . Only you can decide if you meet the work experience requirements. We cannot advise you about that.
 
MARITAL STATUS (Required)  
NUMBER OF CHILDREN (Include all natural children, as well as all legally- adopted children and stepchildren, who are unmarried and under the age of 21) (Required)  
 
FULL NAME AND DATE of BIRTH AND CITY & COUNTRY of BIRTH OF SPOUSE AND EACH CHILD AND SEX of EACH:
Spouse       
Child #1      
Child #2      
Child #3      
Child #4      
Child #5      
Child #6      
Child #7      
Child #8      
 
FULL MAILING ADDRESS
Name (Required)     
Address Line 1 (Required)     
Address Line 2     
Address Line 3     
City (Required)     
District/State/Province (Required)     
Postal Code     
Country (Required)     
   
PHONE (Optional)     
EMAIL ADDRESS        

Step #1 - When all of your entry data above is correct, click on the "Submit Information" button below.

Step #2 - Email us the required digital photos now. Complete instructions on how to prepare your digital photos and how to email them to us are on our web page www.americangreencard.com/howenter.htm.

Step #3 - Send us your service fee for Lottery DV-2010. Complete instructions on how to send your service fee are on our web page www.americangreencard.com/howenter.htm .We will review your entry data and digital photos after receiving our service fee.

 

OUR SERVICE FEE:
$65 for each individual entry.  

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