Follow these instructions carefully to complete the Entry Form.
Type or PRINT neatly and clearly in English.
|1- Applicant's Full Name: Last Name (surname/family), First Name and Middle Name|
|2- Applicant's Date
and Place of Birth: Day, Month, Year -- Example: 14 May
Place of birth: City/Town, District/Province, Country -- Example: Munich, Bavaria, Germany.
The name of the country should be that which is currently in use for the place where the applicant was born (Slovenia, rather than Yugoslavia; Russia rather than Soviet Union, for example).
|3- Applicant's "Native Country", if different from country of birth: If the applicant is claiming nativity in a country other than his or her place of birth, list that country. It can be (1) your spouse's country of birth, or (2) your mother's or father's country of birth, if you were born in a country of which neither was a resident or native.|
|4- Name, Date and Place of Birth of Applicant's Spouse: List your Wife or Husband (if any).|
|5- Name, Date and Place of Birth of Applicant's Children: List your unmarried children under 21 (if any). Unmarried children under 21 may be included on each of their parents' application forms. All children over 21 years of age must file separate applications.|
|6- Applicant's Mailing Address: Give the mailing address where we should notify you if you are selected, and/or to send you further information.|
|7- Applicant's Signature: The applicant must sign the application using his/her normal signature.|
Include a recent "passport style" photograph (1-1/2" x
1-1/2") color or black & white with your name written on the
9- Enclose payment.
FEE: (Check one) __ U.S.$50 for myself __ U.S.$80 for myself and family
Payment enclosed in (Check one):
(NOTE: Make checks payable to: New Americans)
|Mail your Signed
Entry Form, Photograph, Processing fee, and this
Instruction Sheet with the payment information, to the following address:
Please Do NOT fax this FORM; we need the signed Form with photo.