DS-160 Application Form
Wise Elite Solutions Ltd
Personal Information
Full Name (As shown in passport)
Sex
Male
Female
Marital Status
Select
Single
Married
Divorced
Widowed
Date of Birth
Place of Birth
Nationality
National Identification Number
Home Address
Street Address
City
State/Province
Postal Zone/ZIP Code
Country/Region
Is your mailing address the same as home address?
YES
NO
Mailing Address
Street Address
City
State/Province
Postal Zone/ZIP Code
Country/Region
Primary Phone Number
Secondary Phone Number
Work Phone Number
Passport & Travel Information
Passport Number
Passport Book Number
Passport Issuing Authority
City Issued
State/Province Issued
Country/Region Issued
Issuance Date
Expiration Date
Have you ever lost a passport or had one stolen?
YES
NO
Who is paying for your trip?
Have you ever been in the U.S.?
YES
NO
Arrival Date (1)
Departure Date
Remove Visit
+ Add Another Visit
Have you ever been issued a U.S. Visa?
YES
NO
Visa Number (1)
Date Issued
Remove Visa
+ Add Another Visa
Have you ever been refused a U.S. Visa?
YES
NO
Explain
Has anyone ever filed an immigrant petition on your behalf with the United States?
YES
NO
U.S. Contact & Family Information
Contact Person in the U.S.
Contact Person or Organization Name
Organization Name (if applicable)
Relationship to You
Address in the U.S.
Phone Number
Email Address
Father's Information
Surnames
Given Names
Date of Birth
Is your father in the U.S.?
YES
NO
Mother's Information
Surnames
Given Names
Date of Birth
Is your mother in the U.S.?
YES
NO
Do you have a spouse?
YES
NO
Spouse Information
Full Name
Date of Birth
Nationality
City of Birth
Country of Birth
Address
Work & Education
Present Work Information
Primary Occupation
Present Employer or School Name
Employer Address
City
State/Province
Postal Zone/ZIP Code
Country/Region
Start Date
Employer Phone
Monthly Salary
Briefly describe your duties
Were you previously employed?
YES
NO
Employer Name (1)
Address
City
State/Province
Postal Zone/ZIP Code
Country/Region
Phone
Job Title
Supervisor Surname
Supervisor Given Name
Employment From
Employment To
Duties
Remove Employer
+ Add Another Employer
Have you attended any educational institutions at a secondary level or above?
YES
NO
Name of Institution (1)
Address of Institution
City
State/Province
Postal Zone/ZIP Code
Country/Region
Course of Study
Date of Attendance From
Date of Attendance To
Remove Institution
+ Add Another Institution
Additional Information
Do you belong to a clan or tribe?
YES
NO
Clan or Tribe Name
Provide a List of Languages You Speak
X
+ Add Another Language
Have you traveled to any countries/regions within the last five years?
YES
NO
X
+ Add Another Country
Have you belonged to, contributed to, or worked for any professional, social, or charitable organization?
YES
NO
X
+ Add Another Organization
Application Complete!
Click
Submit Application
to finalize.
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