DV Lottery Application

Personal Information

Please provide your basic personal details

First Name *

Enter your legal first name as it appears on your passport

Middle Name

Optional - include if you have a middle name

Last Name *

Enter your legal last name as it appears on your passport

Gender *

Date of Birth *

You must be at least 18 years old

City of Birth *

Country of Birth *

Passport Information

Please provide your current passport details

Passport Number *

Enter the number exactly as it appears on your passport

Passport Expiry Date *

Must be valid for at least 6 months after entry

Country of Issuance *

Contact Information

How can we reach you?

Email Address *

We'll send your confirmation and updates here

Phone Number *

Include country code (e.g., +234 for Nigeria)

Mailing Address *

Your current residential address

City *

State/Province *

ZIP/Postal Code

Family Information

Tell us about your family members

Marital Status *

Number of Children

Photo Upload

Upload a recent passport-style photo

📷

Upload Your Photo

Click to select or drag and drop

Requirements: JPG/PNG, 600x600px, white background

Final Review

Please review all information before submitting

I confirm that all information provided is correct and complete

I agree to the terms and conditions

Personal Information

Passport Information

Contact Information

Family Information

Spouse Information

Children Information

Photo Upload

Upload Your Photo

Final Review

Personal Information

Passport Information

Contact Information

Family Information

Spouse Information

Children Information

Photo Upload

Upload Your Photo

Final Review

Terms & Conditions

Important Disclaimers

Service Details

Payment Information

Payment Successful! 🎉

Application Submitted Successfully

What happens next?