ENTER DV-2021 HERE!

IMPORTANT

The form below was intended for use during the Diversity Visa – 2021 Entry Period which ran from Wednesday, October 2nd to Tuesday, November 5th, 2019, and therefore has no current use until otherwise specified.

DV-2021 ENTRY SUBMISSION FORM

 

  • PART 1: PRIMARY ENTRANT

    Fill in all fields below with accurate and complete information about yourself, the primary entrant.
  • Passport NumberExpiration Date (M,D,Y)Country of Issuance
  • Accepted file types: jpeg, jpg.
    Upload a recently-taken passport size photo of yourself, in JPEG (.jpg) file format, for approval. (The photo is the most critical part of your entry. We will provide you with detailed instructions on taking an acceptable photo in case the one you upload does not meet DV standards).
  • Your spouse (husband or wife) plus all your children below 21 years old equal your total number of secondary entrants. For a single entrant (one without spouse or children), the total number of secondary entrants is 0.
  • PART 2: SECONDARY ENTRANT(S)

    This part ONLY concerns entrants WITH DERIVATIVES (i.e. with wife/husband and/or children below 21 years old). In case you are a SINGLE ENTRANT, proceed to, and read Part 3, at the very end of the form; and then SUBMIT.
  • Part 2A: Spouse Information

    Fill in the fields below with accurate and complete information about the Primary Entrant's Husband or Wife (if applicable).
  • Accepted file types: jpeg, jpg.
    Upload a recently-taken passport size photo, in JPEG (.jpg) file format, for approval. (The photo is the most critical part of your entry. We will provide you with detailed instructions on taking an acceptable photo in case the one you upload does not meet DV standards).
  • Part 2B: Child(ren) Information

    Fill in the fields below with accurate and complete information about each child BELOW 21 years old (if applicable).
  • Child # 1

  • Accepted file types: jpeg, jpg.
    Upload a recently-taken passport size photo, in JPEG (.jpg) file format, for approval. (The photo is the most critical part of your entry. We will provide you with detailed instructions on taking an acceptable photo in case the one you upload does not meet DV standards).
  • Child # 2

  • Accepted file types: jpeg, jpg.
    Upload a recently-taken passport size photo, in JPEG (.jpg) file format, for approval. (The photo is the most critical part of your entry. We will provide you with detailed instructions on taking an acceptable photo in case the one you upload does not meet DV standards).
  • Child # 3

  • Accepted file types: jpeg, jpg.
    Upload a recently-taken passport size photo, in JPEG (.jpg) file format, for approval. (The photo is the most critical part of your entry. We will provide you with detailed instructions on taking an acceptable photo in case the one you upload does not meet DV standards).
  • Child # 4

  • Accepted file types: jpeg, jpg.
    Upload a recently-taken passport size photo, in JPEG (.jpg) file format, for approval. (The photo is the most critical part of your entry. We will provide you with detailed instructions on taking an acceptable photo in case the one you upload does not meet DV standards).
  • Child # 5

  • Accepted file types: jpeg, jpg.
    Upload a recently-taken passport size photo, in JPEG (.jpg) file format, for approval. (The photo is the most critical part of your entry. We will provide you with detailed instructions on taking an acceptable photo in case the one you upload does not meet DV standards).
  • PART 3: ENTRY SUBMISSION COST

    Your DV-2021 Entry Submission Cost is the SUM of the Entry Submission Fee for the Primary Entrant ($30.00) and that of Each Secondary Entrant ($10.00). Pay by PayPal.
  • Price: $0.00

DV-2021 ENTRY SUBMISSION FORM

  • PART 1: PRIMARY ENTRANT

    Fill in all fields below with accurate and complete information about yourself, the primary entrant.
  • Passport NumberExpiration Date (M,D,Y)Country of Issuance
  • Accepted file types: jpeg, jpg.
    Upload a recently-taken passport size photo of yourself, in JPEG (.jpg) file format, for approval. (The photo is the most critical part of your entry. We will provide you with detailed instructions on taking an acceptable photo in case the one you upload does not meet DV standards).
  • Your spouse (husband or wife) plus all your children below 21 years old equal your total number of secondary entrants. For a single entrant (one without spouse or children), the total number of secondary entrants is 0.
  • PART 2: SECONDARY ENTRANT(S)

    This part ONLY concerns entrants WITH DERIVATIVES (i.e. with wife/husband and/or children below 21 years old). In case you are a SINGLE ENTRANT, proceed to, and read Part 3, at the very end of the form; and then SUBMIT.
  • Part 2A: Spouse Information

    Fill in the fields below with accurate and complete information about the Primary Entrant's Husband or Wife (if applicable).
  • Accepted file types: jpeg, jpg.
    Upload a recently-taken passport size photo, in JPEG (.jpg) file format, for approval. (The photo is the most critical part of your entry. We will provide you with detailed instructions on taking an acceptable photo in case the one you upload does not meet DV standards).
  • Part 2B: Child(ren) Information

    Fill in the fields below with accurate and complete information about each child BELOW 21 years old (if applicable).
  • Child # 1

  • Accepted file types: jpeg, jpg.
    Upload a recently-taken passport size photo, in JPEG (.jpg) file format, for approval. (The photo is the most critical part of your entry. We will provide you with detailed instructions on taking an acceptable photo in case the one you upload does not meet DV standards).
  • Child # 2

  • Accepted file types: jpeg, jpg.
    Upload a recently-taken passport size photo, in JPEG (.jpg) file format, for approval. (The photo is the most critical part of your entry. We will provide you with detailed instructions on taking an acceptable photo in case the one you upload does not meet DV standards).
  • Child # 3

  • Accepted file types: jpeg, jpg.
    Upload a recently-taken passport size photo, in JPEG (.jpg) file format, for approval. (The photo is the most critical part of your entry. We will provide you with detailed instructions on taking an acceptable photo in case the one you upload does not meet DV standards).
  • Child # 4

  • Accepted file types: jpeg, jpg.
    Upload a recently-taken passport size photo, in JPEG (.jpg) file format, for approval. (The photo is the most critical part of your entry. We will provide you with detailed instructions on taking an acceptable photo in case the one you upload does not meet DV standards).
  • Child # 5

  • Accepted file types: jpeg, jpg.
    Upload a recently-taken passport size photo, in JPEG (.jpg) file format, for approval. (The photo is the most critical part of your entry. We will provide you with detailed instructions on taking an acceptable photo in case the one you upload does not meet DV standards).
  • PART 3: ENTRY SUBMISSION COST

    Your DV-2021 Entry Submission Cost is the SUM of the Entry Submission Fee for the Primary Entrant ($30.00) and that of Each Secondary Entrant ($10.00). Pay by PayPal.
  • Price: $0.00