DV 2027 FAMILY APPLICATIONS - Immigration Services

Welcome to the EBM SCHOLARS Diversity Visa Program Application Support System.

Once our staff completes the form, please carefully review all the information to ensure it is accurate and all spellings are correct. The details provided here will be used to complete your official Diversity Visa (DV) Lottery application.

- Step 1 of 5

APPLICATION NUMBER *

MPESA PAYMENT CONFIRMATION CODE *

NAME OF STAFF FILLING OUT THE FORM *

PLEASE MAKE SURE CUSTOMER REVIEWS AND APPROVES THE INFORMATION FILLED BEFORE SUBMISSION

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.

9. City Where You Live Today *

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

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

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

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

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

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

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

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