Template Application for U.S.

Visa to be completed by Qatar Airways Cabin Crew

(This is only a template application for Qatar Airways Purposes Only)

Save the application on your desktop before working on the form.

Please note that fields with (*) are mandatory – if fields are left blank, the application will be considered void.
Should you require any further assistance please do not hesitate to contact us on 44236800 Ext. 09

Staff Number* Interview Date*

Reference Number*

First Name* Middle Name*

Last Name*

Gender* Male ● Female

Date of Birth* Mobile No*

Marital Status* e-mail*

Applicable only if you have any legal documents to claim that you had / have other Surnames / Given names

Have you ever used other Names (Maiden/Religious/Professional)*

If Yes, please provide the following:

Other Surnames Used Other Given Name Used

City of Birth* Country of Birth*

Nationality*

Do you hold another If Yes,

Nationality?* Nationality?

If Yes, Please provide the following: Do you hold a passport for this nationality?

if Yes, Provide the passport number

Residence permit No*

Passport No*

Passport Book No Country of the Passport/

(South American Authority that issued
Nationalities only) Passport*
 City the Passport Country the Passport was
was issued* issued*

Passport Issuance Passport Expiry Date*

Date*

Have you ever lost a passport or had one stolen?*

If Yes, Please provide the following: Explain

Lost Passport No Country of Passport

Have you ever been

to U.S.?*

Date of Arrival* Length of Stay*

Do you or did you hold a U.S. driver's License*

Driver's License No. State of Driver's License

Have you ever been Are you applying for the same
issued a U.S. VISA* type of visa*

Visa Number* Last visa issuance date

Are you applying in the same country as the above visa

and is this country your principal country of residence?

Have you been ten Has your US visa been stolen or

printed? Lost?

Has your U.S. visa been cancelled or revoked?*

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admission to the United States, or withdrawn your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?*

Father's Information Mother's Information

Surname* Surname*

Given Name* Given Name*

Date of Birth* Date of Birth*

Is he in U.S.?* Is she in U.S. ?*

Visa Status Visa Status

 Do you have any immediate relatives, not including parents, in the
United States?(Blood Relation)*

If Yes, Please provide the following:

Surname Given Name

Relationship to you Visa Status

Do you have any other relatives in the United States?*

If applicant is married, Spouse Information:

Surname Given Name

Date of Birth Nationality

City of Birth Address

Country of Birth

If Divorced/Separated/Widow, former spouse Information: Number of former spouse

Please specify former spouse information;

Surname Given Name

Date of Birth Nationality

City of Birth Country of Birth

Date of Marriage Date of Marriage Ended

How the marriage Ended Country Marriage was terminated

Were you previously employed? (Provide information for the last

five Years)*

If Yes, Please provide the following:

Employer Name Employer

Address

City Country

Job Title Supervisor Full Name

Employee date from Employee date to

Briefly Describe Duty Telephone No

 Have you attended any educational institutions other than
elementary school?*

If Yes, please provide the following:

Institute Name Address

City Country

Course of Study

Date from Date to

Do you belong to a clan or tribe?*

Please Provide all the countries that you have entered in the last five years, both personally
and as a cabin crew member (You are required to mention at least 10 - layover countries)

1.* 2.* 3.*

4.* 5.* 6.*

7.* 8.* 9.*

10.* 11. 12.

13. 14. 15.

Please answer the following questions honestly

Have you belonged to, contributed to, or worked for any professional, social,
or charitable organizations?*

Do you have any specialized Skills or training in firearms, explosives, nuclear,

biological, or chemical experience?*

Have You ever served in the military?*

If Yes, please provided the following:

Name of Country Branch of Service

Rank/position Military Speciality

Service from till

Have you ever served in, been a member of, or been involved with a
paramilitary unit, vigilante unit, rebel group, guerrilla group, or insurgent
organization?*
 Do you have a communicable disease of public health significance such as
tuberculosis (TB)?*

Do you have a mental or physical disorder that poses or is likely to pose a

threat to the safety or welfare of yourself or others?*

Are you or have you ever been a drug abuser or addict?*

Have you ever been arrested or convicted for any offense or crime, even
though subject of a pardon, amnesty, or other similar action?*

Have you ever violated, or engaged in a conspiracy to violate, any law relating
to controlled substances?*

Are you coming to the United States to engage in prostitution or unlawful

commercialized vice or have you been engaged in prostitution or procuring
prostitutes within the past 10 years?*

Have you ever been involved in or do you seek to engage in money

laundering?*

Do you seek to engage in espionage, sabotage, export control violations, or

any other illegal activity while in the United States?*

Do you see to engage in terrorist activities while in the United State or have
you ever engaged in terrorist activities?*

Have you ever or do you intend to provide financial assistance or other

support to terrorists or terrorist organizations?*

Are you a member or representative of a terrorist organization?*

Have you ever committed, ordered, incited, committed, assisted, or otherwise

participated in torture?*

Have you committed, ordered, incited, committed, assisted, or otherwise

participated in extra judicial killings, political killings, or other acts of
violence?*
 Have you, while serving as a government official, been responsible for or
directly carried out, at any time particularly severe violations of religious
freedom?*

Have you ever sought to obtain or assist other to obtain a visa, entry into the
United States or any other United Sates immigration benefit by fraud or wilful
misrepresentation or other unlawful means?*

Have you ever withheld custody of a U. S. citizen child outside the United
States, from a person granted legal custody by a U. S. court?*

Have you voted in the United States in violation of any law or regulation?*

Have you ever renounced United States citizenship for the purpose of
avoiding taxation?*