DV LOTTERY FORM - Immigration Services

EBM SCHOLARS DV LOTTERY APPLICATION FORM

EBM SCHOLARS offers expert assistance for DV Lottery (Green Card Lottery) applications at an affordable price of USD 10 per person. It does not matter whether or not you have dependents, the fee is the same. Fill out the form below for each qualified member (main applicant and derivatives, if you have), and upload photos for each person in the appropriate part. You can upload more than one photo per person, so that we can choose which one is better, so that we can edit and put the photo into proper DV Lottery Photo Measurements.

Make sure you make payment of USD 10. Once you submit your form with payment, through Visa or MasterCard, we will send the Confirmation Number.

- Step 1 of 5

Part One - Entrant Information

1. Name *

First

Middle

Last

2. Gender *

3. Date of Birth (Month, Date, Year) Write month in words, example February 10, 1999 *

4. City Where You Were Born *

5. Country You Were Born *

6. Country of Eligibility (Write country you were born, unless you were born in a country not eligible) *

7. Entrant Photograph (Upload all photos you need me to use. Each photo indicate the name of the person, if you have a a family). EBM SCHOLARS Team will edit for you to put in proper measurements.

Click or drag files to this area to upload. You can upload up to 20 files.

8. Address Where You Live Today *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

9. Country Where You Live Today *

10. Phone Number

11. E-Mail Address *

Confirm Email

12. What is the highest level of education you have achieved, as of today? SELECT ONE *

Primary School Only
High School, no degree
High School Degree
Vocational School
Some University Courses
University Degree
Some Graduate Level Courses
Master's Degree
Some Doctorate Level Courses
Doctorate Degree

13. What is your current marital status? *

Unmarried (SINGLE)
Married and my spouse is NOT a U.S. Citizen or Green Card Holder
Married and my spouse IS a U.S. Citizen or Green Card Holder
Divorced
Widowed
Legally Separated by the Court Order

14. Number of Children *

Part Two: Derivatives (if you are married or have children)

15. SPOUSE (IF YOU ARE MARRIED AND SPOUSE IS NOT GREEN CARD HOLDER OR U.S. CITIZEN)

First

Middle

Last

Date of Birth (Start with Month, Date, Year)

Gender

City Where Spouse Was Born

Country Where Spouse Was Born

Spouse Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Upload digital photo in JPG, JPEG or PNG for us to edit

Email *

What is your Spouse's Highest Education Level Attained?

WhatsApp Phone Number

City and County Where You Live Today

CHILDREN OF THE MAIN APPLICANT

ADD YOUR CHILDREN (Biological, Stepchildren, Legally adopted children) MUST BE Under 21 years and unmarried

CHILD #1

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILDREN OF THE MAIN APPLICANT

ADD YOUR CHILDREN (Biological, Stepchildren, Legally adopted children) MUST BE Under 21 years and unmarried

CHILD #1

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILD #2

CHILD #

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILDREN OF THE MAIN APPLICANT

ADD YOUR CHILDREN (Biological, Stepchildren, Legally adopted children) MUST BE Under 21 years and unmarried

CHILD #1

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILD #2

Write full name starting with First, Middle, Last

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILD #3

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILDREN OF THE MAIN APPLICANT

ADD YOUR CHILDREN (Biological, Stepchildren, Legally adopted children) MUST BE Under 21 years and unmarried

CHILD #1

Full name start First, Middle, Last

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILD #2

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILD #3

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILD #4

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILDREN OF THE MAIN APPLICANT

ADD YOUR CHILDREN (Biological, Stepchildren, Legally adopted children) MUST BE Under 21 years and unmarried

CHILD #1

Full name start First, Middle, Last

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILD #2

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILD #3

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILD #4

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILD #5

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILDREN OF THE MAIN APPLICANT

ADD YOUR CHILDREN (Biological, Stepchildren, Legally adopted children) MUST BE Under 21 years and unmarried (copy)

CHILD #1

Full name start First, Middle, Last

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILD #2

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILD #3

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILD #4

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILD #5

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

CHILD #6

First

Middle

Last

Birth Date (Start with Month, Date, Year)

Gender

City Where Child Was Born

Country Where Child Was Born

Child Photograph

Click or drag files to this area to upload. You can upload up to 5 files.

Color of cloth the child on the photo is wearing

SERVICE PAYMENT

Payment for Photo Editing, Online Application and Receiving Confirmation Number from EBM SCHOLARS Team

Price: $ 10.00

Visa or MasterCard (Debit or Credit) *

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