DS-160 Non-immigrant Visa application

The link for the website is:

https://ceac.state.gov/genniv/

Please remember that if there is no activity on your computer for more than 20 minutes your session
will expire and you will lose all data entered and have to start from the beginning. So it is advisable
to save your application as you complete it.

The questions are pretty straightforward. There is a HELP section to the right of each question
elaborating on what is required. So please read that before answering each question.

When you select the location where you will be submitting your application, this refers to the
specific U.S Consulate in South Africa. Please note that you should apply in the Consular district
where you live:

Cape Town: Eastern Cape, Western Cape and Northern Cape Provinces
Durban: Kwazulu – Natal Province
Johannesburg: Free State, Gauteng, Limpopo, Mpumalanga and the North West Provinces

The Consular Electronic Application Center will permit you to complete an application online. If you have to
stop the application before it has been completed for whatever reason then you MUST:

Click the “Save” button at the bottom of the last page you have completed and follow the instructions to save.

When you return to the Consular Electronic Application Center, click on the “Retrieve Application” button to
access the previously saved file.

Location Information

Location where you will be submitting your application: HARARE

(Where you live – if not sure check with Awesome Travel BEFORE you start your application)

Personal, Address, Phone, and Passport Information

Surname: _________________________________________________

Given Names: _________________________________________________

Full name in native language: “DOES NOT APPLY” _________________________________

Other names used: _________________________________________________

Telecode which represents your name: Tick No __________________________________________

Sex: _________________________________________________

Marital status: _________________________________________________

Date of birth: _________________________________________________

City of birth: _________________________________________________

Country of Birth: _________________________________________________

Nationality: _________________________________________________

Other nationalities: _________________________________________________

If you do hold any other nationality don’t skip simply to input less information as this equates to a lie
and your application can be denied!

National Identification number: _________________________________________________

U.S. Social Security Number: “DOES NOT APPLY” _________________________________

If you have worked in the US before then you will need to input your Social Security Number

U.S. Taxpayer ID Number: ‘DOES NOT APPLY”__________________________________

Home Address: _________________________________________________

City: _________________________________________________

State/Province: _________________________________________________

Postal Zone/Zip Code: _________________________________________________

Country: _________________________________________________

Same Mailing address: YES/NO __________________________________________

If No, input Mailing Address: ______ _________________________________________

City: _________________________________________________

State/Province: _________________________________________________

Postal Zone/Zip Code: _________________________________________________

Country: _________________________________________________

Primary Phone Number: ______ __________________________________________

Secondary Phone Number: _________________________________________________

Work Phone Number: _________________________________________________

Email address: _________________________________________________

Passport/Travel Document type: REGULAR_________________________________________

Passport Number: _________________________________________________

Passport Book Number: “DOES NOT APPLY” _________________________________

Country/Authority that issued passport: _________________________________________________

City where issued: _________________________________________________

State/Province (if shown in passport): LEAVE BLANK

Country where issued: _________________________________________________

Issuance date: _________________________________________________

Expiration date: _________________________________________________

Have you ever lost a passport _________________________________________________

Or had one stolen?

Travel Information

Purpose of trip to the US? Exchange Visitor (J) ________________________________

Specify? Click on Exchange Visa (J1)___________________________

Have you made specific travel plans? No_______________________________________________

Intended date of Arrival: 20 July 2022

Intended length of stay in U.S. 12 months

Address where you will stay in the U.S:

The Big Cedar Lodge: 190 Top of the, Rock Road

Ridgedale, Missouri

65739

417 - 339 - 5172

Person/Entity paying for your trip? Other

Relationship to you Parent

Is address of party paying for your trip

the same as your Home or Mailing
address: YES/ NO, if no provide the details

Other persons travelling with you? NO

Are you travelling as part of a group? NO

Have you ever been in the U.S? YES/NO If yes, provide dates of entry

Have you ever been issued a U.S visa? YES/NO If yes provide details

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?
YES/NO If yes, _________________________________________________________
Has anyone ever filed an immigrant petition on your behalf with the United States Citizenship and
Immigration Services?
YES/NO If Yes________________________________________________________
U.S Contact Information
Contact Person Name in the U.S: “DO NOT KNOW”

Organization Name in the U.S: Put Employers name (The Big Cedar Lodge)

Relationship to you: Employer

U.S Contact address: See previous page for your specific employers details

Phone number: The Big Cedar Lodge (417 – 339 - 5172)

Email address: “DOES NOT APPLY”

Family Information/Relatives
Father’s Surnames: _________________________________________________

Father’s Given Names: _________________________________________________

Father’s Date of Birth: _________________ If you don’t know, then find out!

Is your father in the U.S? _________________________________________________

Mother’s Surnames: _________________________________________________

Mother’s Given Names: _________________________________________________

Mother’s Date of Birth: ________________ If you don’t know, then find out!

Is your mother in the U.S? _________________________________________________

Do you have any immediate relative’s _________________________________________________

Not including parents in the U.S (Immediate means fiancé/fiancée, spouse (husband/wife), child
(son/daughter), or sibling (brother/sister)

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

Work/Education/Training information
Primary Occupation: PUT WHERE YOU ARE CURRENTLY WORKING, IF YOU ARE A
STUDENT WRITE YOUR SCHOOL INFO

Present Employer or School Name: _________________________________________________

Address: _________________________________________________

City: _________________________________________________

State/Province: _________________________________________________
Postal Zone/Zip Code: _________________________________________________

Country: _________________________________________________

Monthly Salary in local currency: (tick the box as it does not apply)
______________________________________________

Briefly describe your duties: _________________________________________________

Were you previously employed: YES, (Add your school practical work)

Employer Name (1): _________________________________________________

Employer Address: _________________________________________________

City: _________________________________________________

State/Province: _________________________________________________

Postal Zone/Zip Code: _________________________________________________

Country: _________________________________________________

Telephone Number: _________________________________________________

Job Title: _________________________________________________

Supervisor’s Name and Surname: _____________ ____________________________________

Employment date From: ______ __________________________________________

Employment date To: _________________________________________________

Briefly describe your duties: _________________________________________________

(ADD MORE EMPLOYERS IF YOU WORKED FOR MORE THAN 1 EMPLOYER, YOU CAN ADD UP TO 2
EMPLOYERS)

Have you attended any educational _________________________________________________

Institutions at a high school level or above?

Name of Institution (1): _________________________________________________

Address of Institution: _________________________________________________

City: _________________________________________________

State/Province: _________________________________________________

Postal Zone/Zip Code: _________________________________________________

Country: _________________________________________________
Course of study? _________________________________________________

Date of Attendance from: _________________________________________________

Date of Attendance to: _________________________________________________

Do you belong to a clan or tribe? _________________________________________________

Provide a list of languages you speak? _________________________________________________

Have you travelled to any countries

within the last 5 years? List them ________________________________________________

Have you belonged to, contributed to,

Or worked for any professional, social, or charitable organization?____________________________

Do you have any specialised skills or training,_____________________________________________

Including firearms, explosives, nuclear, biological, or chemical experience?

Have you ever served in the military? _________________________________________________

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? _____________________________________

Security and Background Information (YES/NO)

Do you have a communicable disease of public health significance? (Communicable diseases of

public significance include chancroid, gonorrhea, granuloma inguinale, infectious leprosy,
lymphogranuloma venereum, infectious stage syphilis, active tuberculosis, and others diseases as
determined by the Department of Health and Human Services.) ____________________________

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 offence 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? ________________

Have you ever committed or conspired to commit a human trafficking offense in the United States or
outside the United States?___________________________________________________________
Have you ever knowingly aided, abetted, assisted or colluded with an individual who has committed,
or conspired to commit a severe human trafficking offense in the United States or outside the United
States? ___________________________________________________________________________

Are you the spouse, son, or daughter of an individual who has committed or conspired to commit a
human trafficking offense in the United States or outside the United States and have you within the
last five years, knowingly benefited from the trafficking activities? ___________________________

Do you seek to engage in espionage, sabotage, export control violations, or any other illegal activity
while in the United States? ___________________________________________________________

Do you seek to engage in terrorist activities while in the United States 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 ordered, incited, committed, assisted, or otherwise participated in genocide? ______

Have you ever committed, ordered, incited, assisted, or otherwise participated in torture? ________

Have you committed, ordered, incited, assisted, or otherwise participated in extrajudicial 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 been directly involved in the establishment or enforcement of population controls
forcing a woman to undergo an abortion against her free choice or a man or a woman to undergo
sterilization against his or her free will?________________________________________________

Have you ever been directly involved in the coercive transplantation of human organs or bodily
tissue? _________________________________________________________________________

Have you ever sought or obtain or assisted others to obtain a visa, entry into the United States, or
any other United States 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 Unites States citizenship for the purpose of avoiding taxation? _________

Additional Point of Contact

List two contacts in your country of residence who can verify the information you have provided in
your application. No immediate family or relatives and not an Awesome Travel representative:
Name 1: _________________________________________________
Street Address: _________________________________________________
City: _________________________________________________
State/Province: _________________________________________________
Postal Zone/Zip Code: _________________________________________________
Country: _________________________________________________
Telephone Number: _________________________________________________
Email address: _________________________________________________
Name 2: _________________________________________________
Street Address: _________________________________________________
City: _________________________________________________
State/Province: _________________________________________________
Postal Zone/Zip Code: _________________________________________________
Country: _________________________________________________
Telephone Number: _________________________________________________
Email address: _________________________________________________

SEVIS-Student Exchange Visitors Information Service

SEVIS ID: _____N0001234567 (Dummy number)_____________
Program No: P-3-05133 for a student
Do you intend to study in U.S? NO

Do Not Sign & Submit Before Awesome Travel Has Reviewed Your Application

Please DO NOT submit your

application before sending it to
Pleas
Awesome Travel after completing
e
your SEVIS section to review it
Note
FIRST!
An applicant is required to sign and submit his/her own non-immigrant visa application.
Although an applicant may receive assistance from a third party, the applicant is required to click the
“Sign Application” button at the end of the application.
You will add that you received assistance in completing the application by answering Yes to the
question whether you had assistance completing the form: So Tick Yes and then fill in the following:
Name and Surname: Tick box “does not apply”
Organization Name: Awesome Travel
Address: 40A Sturdee Avenue, Rosebank, 2196, Johannesburg, Gauteng
Relationship to You: Work Agent

BEFORE
You sign and Submit by entering the unique code that is shown in the black box, you MUST send your
application ID, secret question and answer to Awesome Travel for one final review.