Email

City and Country of Birth

Citizenship(s)

Marital Status

Preferred Language(s)

Other Countries Where You Have Lived (5+ months)

Do you have a specific visa or program in mind?

Have you ever applied for a visa or immigration to another country? If yes, provide details (country, type, year, outcome)

Have you ever overstayed a visa, been denied entry, or deported? If yes, provide details:

Do you currently have legal status in any country besides your country of citizenship? If yes, provide type of status and expiration:

Do you hold any current visas or permanent resident status? If yes, list countries and visa types:

Spouse/Partner’s Name and Citizenship(s)

Children’s Full Names, Dates of Birth, and Nationalities

Are any family members currently citizens or residents of the destination country? If yes, explain:

Highest Level of Education Completed

Institution Name, Location, and Degree

Current Occupation / Job Title

Employer Name and Location

Work History (last 5 years or more)

Include country, job title, and dates

Have you ever been charged or convicted of a crime in any country?

If yes, provide brief details:

Do you have any serious health conditions that require ongoing treatment?

If yes, explain:

Have you ever claimed asylum or refugee protection?

If yes, when and where:

Do you have a job offer, school acceptance letter, or sponsorship letter?

If yes, describe:

Any additional facts or concerns you would like us to know?

Global Visa Assistance Intake Form