Visa Denial Information Request Form

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Please fill out the following form completely. Upon reviewing the information you will be contacted if there are any legal options available.

Last Name *

First Name *

Email Address *

Phone Number *

Date of Birth *

YYYY

Nationality *

Current Country of Residence *

What type of visa did you apply for? *

Have you received a response regarding your application? *

When did you apply for your visa? *

Did you have an interview for your visa? If yes, what is the name of the embassy where you were interviewed? *

After your interview did you receive a request for documents, call or email from the embassy? If yes, what did they say? *

If granted the visa, where in the U.S. did you intend on traveling to? For what reasons? *

Do you have family in the United States? *

Yes

Do you have a job offer in the United States? *

Yes

Do you have university acceptance to go to school in the United States? *

Yes

Have you received a visa to enter the U.S. before? If so, what year and what type of visa? *

Have you visited the U.S. before for any reason? If so, where did you go in the U.S.? *

If you have entered the U.S. before, did you have any trouble obtaining a visa for entry or entering the country?

Did you consult with an attorney when filling out and filing your visa application? If so, what is his/her contact information? *

Did you consult with anyone other than an attorney when filling out and filing your visa application? If so, who? *

Do you have any other information you would like to provide regarding your visa application denial?

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