Personal Details
- Full Name:
- Other Names/Surname Used:
- Marital Status:
- Date and Place of Birth:
- Nationality:
- Citizenship No.
- Current Address:
- Home Phone No:
- Work Phone No.:
- Mobile No:
- Email:
- Additional mobile number and email if you have used in the last five years:
- Do you have a social media presence?
Passport Details:
- Passport
- Have you ever lost a passport or had one stolen? If yes give Lost PP No. & explain:-
Travel Information
- Have You Made Specific Travel Plan?
- Address where you will stay in the U.S.:
- Name of Person Paying for Your Trip:
- Telephone:
- Email Address (If Applicable):
- Is the address of the party paying for your trip the same as your Home or Mailing Address? (If No, Give Full Address)
Travel Companions Information
- Persons Traveling with You:
- Relationship to You:
Previous U.S. Travel Information
- Have you ever been in the U.S.?
- Do you or did you hold a U.S. Driver's License?
- Have you ever been issued a U.S. Visa?
- Have you ever been refused a U.S. Visa, been refused admission to the United States or withdrawn your application for admission at the point of entry?
- Has anyone ever filed an immigrant petition on your behalf with the United States Citizenship and Immigration Services? (If Yes, explain)
U.S. Contact Information
- Contact Person Name in the U.S.:
- Organization Name in the U.S.(If Applicable):
- Relationship to You:
- U.S. Contact Address:
- Phone Number:
- Email Address (If Applicable):
Family Information
- Father's Name:
- Father's Date of Birth (If Applicable):
- Is you Father in USA?
- Mother's Name:
- Mother's Date of Birth (If Applicable):
- Is you Mother in USA?
- Do you have any immediate relatives, not including parents in the U.S.?
- Do you have any other relatives in the U.S.?
- Spouse's Full Name:
- Spouse's Date, Place & Country of Birth:
- Spouse's Nationality:
- Spouse’s Address:
Work / Education / Training Information
- Present Employer or School Name:
- Address:
- Job Start Date:
- Monthly Salary in Local Currency (if employed):
- Briefly Describe your Duties:
- Were you previously employed in the last five years? (If yes, give details) (Maximum Two Employers)
- Employer Name:
- Employer Address:
- Phone No:
- Job Title:
- Supervisor's Name:
- Employment Date (dd/mm/yy)
- From:
- To:
- Briefly describe your duties:
- Have you attended any educational institutions other than elementary schools?
- Name of Institution:
- Full Address of Institution:
- Course of Study: Phd/Master/Bachelor/10+2/S.L.C.
- Date of Attendance (mm/yy) From:
- Date of Attendance (mm/yy) To:
Additional Information
- Provide a list of languages you speak :
- Have you traveled to any countries within the last five years? (Give name of the countries)
- Have you belonged to contributed to or worked for any professional social or charitable organization? (Give name of the organization)
Student/Exchange Visa Information (Only for F1/J1/M1)
Additional Point of Contact Information (Do not list family members and other relatives (At least two):
- Name:
- Full Address:
- Telephone Number:
- Email Address (if applicable):
- SEVIS ID:
- Program Code:
- I-20 for F1/M1
- DS-2019 for J1
Required Details in Nepali Language

Photo
Your US visa photos must be:
- The US visa photo size should be 2 x 2 inches (50 x 50 mm).
- The photo should be positioned in a way that the head is between 1 and 1 3/8 inches (22 mm and 35 mm) or 50% and 69% of the image’s total height from the bottom of your chin to the top of the head.
- In color.
- Taken within the last 6 months.
- With no shadows.
- With a plain white background.
- You must face the camera in the photo.
- Have a neutral expression.
- Have both eyes open.
- Do not wear eyeglasses, hat or head covering that obscures the hair or hairline


Passport
- Original Current Passport
- Original Previous Passport (If you have US Visa in previous passport)