Please fill this form and send it to this email:
lottery_greencard@yahoo.com

One Person: Fee 22 $
1. Name:............
2. Family name:.................
3. Date of Birth:....................
4.Place of Birth:........................
5. Address:..........................
Town/city:..............state:............ zip code:...............
country:.............
6. A valid email:...................................
7.A recent passport photo: No sunglasses.No hat. No veil for traditional use. If the veil ( covering of the head ) is for a religious practice, it is accepted.
The digital photo should be .jpg ( jpeg) format.It must not exceed 240 kilo bytes .It must be 600 pixels in 600 pixels

Family: Fee 40 $
Note:
You can enter two registrations, one for you as the principle applicant and the second one for your wife.
If so, the fee is 70 $.( a reduction of 10 $)
This will help to get two chances. If one wins he will emigrate with the whole family.
Well if you are married, and you do not include your wife and children and suppose you win the DV Lottery, they could not emigrate with you.
So be careful.
Husband: Main applicant
1. Name:............
2. Family name:.................
3. Date of Birth:....................
4.Place of Birth:........................
5. Address:..........................
Town/city:..............state:............ zip code:...............
country:.............
6. A valid email:...................................
7.A recent passport photo: No sunglasses.No hat. No veil for traditional use. If the veil ( covering of the head ) is for a religious practice, it is accepted.
The digital photo should be .jpg ( jpeg) format.It must not exceed 240 kilo bytes .It must be 600 pixels in 600 pixels

Wife:
1. Name:............
2. Family name:.................
3. Date of Birth:....................
4.Place of Birth:........................
5. Address:..........................
Town/city:..............state:............ zip code:...............
country:.............
6. A valid email:...................................( if different from the husband email)
7.A recent passport photo: No sunglasses.No hat. No veil for traditional use. If the veil ( covering of the head ) is for a religious practice, it is accepted.
The digital photo should be .jpg ( jpeg) format.It must not exceed 240 kilo bytes .It must be 600 pixels in 600 pixels

Children
1. Name:............
2. Family name:.................
3. Date of Birth:....................
4.Place of Birth:........................
5.A recent passport photo: No sunglasses.No hat. No veil for traditional use. If the veil ( covering of the head ) is for a religious practice, it is accepted.
The digital photo should be .jpg ( jpeg) format.It must not exceed 240 kilo bytes .It must be 600 pixels in 600 pixels

Warning:
Please do not register twice as the principle applicant, because the USA Department of State will eradicate your entries.
No Refund Policy
Please read the Terms and Conditions before you register and send your fee.
How to Pay the Fee
Please contact us for more information.