Green Card Application

Apply for 2010 Green Card Lottery Assistance for Electronic Application
Getting started: If you qualify please complete the form below.

Apply now online to have your Green Card Lottery registration form submitted
electronically by the deadline. Or you can apply by mail.

Submitting your application in a timely manner is very important!
Applying later than December 1, 2008 could eliminate your application from being
submitting by the deadline set by the Diversity Visa Program.

1. Complete the application below. Make sure to send a correct mailing address
     and e-mail address so we can contact you on the progression of your application.

2. Submit digital passport style photos of yourself, your spouse and all children listed on your
application to lottery@immigrationweb.org .
Be sure to add your full name and e-mail address.

3. Submit a payment of $30.00 thru PayPal. If you prefer, you can apply by mail.
    Participating in DV-2010 is free of charge. The charge is for application services
    rendered by Immigration Web. All proceeds go to Culture Connection, a
    nonprofit organization established to help immigrants adjust to a new way of life
    in the United States.

You do not need a PayPal account to use PayPal. Credit and Debit cards are accepted.

Last Name
First Name
Middle Name	Gender
Date of Birth	(Month/Day/Year)
Birth/City or Town
Birth/Country
Native Country	(If other than Birth Country)
Mailing Address
City orTown
District/Province/State
Postal Code or Zip Code
Country
Email Address
Legally Married
Children	Unmarried under the age of 21, that are not United States citizens or permanent residents

Spouse Information (if applies)

Spouse's Last Name
Spouse's First Name
Spouse's Middle Name	Gender
Spouse's Date of Birth	(Month/Day/Year)
Spouse's Birth/City or Town
Spouse's Birth/Country
Spouse's Native Country	(If other than Birth Country)

Information about Children- unmarried under the age of 21, that are not United States citizens
or permanent residents (if applies)

Children's Information Full name
(Last, First, Middle) Birth Dates Gender Country of Birth City or Town of Birth

Check if you have a high school education or have completed a 12-year elementary education or have at least 2 years ofwork experience in the last 5 years requiring 2 years training or experience to perform.

How many years of education have our completed?

This web site has been prepared for general information purposes only. The information on this web site is not legal advice. Legal advice is dependent upon the specific circumstances of each situation. Finally, the information contained in this web site is not guaranteed to be up to date. Therefore, the information contained in this web site cannot replace the advice of competent legal counsel licensed in your state