Register for the 2019 Green Card Lottery

All Fields Required

First Name:

Last Name:

Your Country of Birth:

Your Country of Residence:

Are you married?

Yes

Your Spouse's Country of Birth:

Your Father's Country of Birth:

Your Mother's Country of Birth:

Have you finished high school?
(Or completed 12 years of elementary studies?)

Yes

Do you have two years of work experience?

Yes

Email:

Confirm Email:

Password:

Confirm Password:

Phone: (Home/Office)

* The Telephone Number helps us to contact you when you win

Phone: (Mobile)

* The Mobile Number helps us to contact you when you win

I would like to receive updates about the Green Card Lottery

Register Today to Live and Work in America!