U.S DIVERSITY VISA LOTTERY APPLICATION (DV-2008)
Enter information before printing OR print then fill

Applicant's Last Name

First Name

Middle

Date of Birth (Day/Month/Year)

Place of Birth (City/Town, Country)
Male    Female Unmarried;Married;Divorced;Widowed;Legally Separated
Which one of the following
represents your own highest
level of educational achievement:
Primary school only;High school, no degree;
High school degree;Vocational school;
Some university courses; University degree;
Some graduate level courses; Master degree;
Some doctorate level courses; Doctorate degree;

Applicant's Native Country, ONLY if different from country of birth
Name, date and place of birth of the Applicant's Spouse and Children (IF ANY)

Spouse Last Name

First Name

Middle

Date of Birth (Day/Month/Year)

Place of Birth (City/Town, Country)

Child 1 Last Name

First Name

Middle

Date of Birth (Day/Month/Year)
    MaleFemale
Place of Birth (City/Town, Country)

Child 2 Last Name

First Name

Middle

Date of Birth (Day/Month/year)
    MaleFemale
Place of Birth (City/Town, Country)

Child 3 Last Name

First Name

Middle

Date of Birth (Day/Month/year)
    MaleFemale
Place of Birth (City/Town, Country)
If you have more than 3 children list them on the back of the application



Remember to include one Photo
For each family member listed on the application

write name on the back

Please do not attach.











PAYMENT -- Make payment to: VisaPeople/AGCLC 
Our processing fee is only $45 (U.S dollars) for one application, and only $70 for a married couple submitting two separate applications (one for husband and one for wife). You can save by applying for 2 years, 3 years or 6 years. Check proper box below.
One Year:  $45    $70 (husband and wife)
Two years:  $80    $125 (husband and wife)
Three years:  $105   $165 (husband and wife)
  Six years: $150  $245 (husband and wife)
All kinds of Money Orders are accepted -- No refund after we file your application
Select Method of Payment: 
Select Credit Card: 
Credit Card information will NOT go over the internet--You can fill it by hand if you wish 
Card Number: 
Expiration Date:  (Month/Year)
Card Holder’s Name: 
Card Holder’s Signature: 
Please provide your contact information below
Name: 
Email_1: 
Email_2: 
Mailing Address: 

Telephone: 
Mail this page and the Application
to our office with:
1) Photo(s) and 2) Processing fee.
VisaPeople
P.O Box 519
Annandale, VA 22003
USA
.
If you sending the application by a Courier (UPS, DHL, FedEX, TNT, etc.), please use this address. VisaPeople
4200 Whitney St. #40
Annandale, VA 22003
USA
.
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