DV Lottery Registration Form Simulator

This is a training simulator based on the general structure of the official Diversity Visa (DV) Lottery entry form. It is intended for practice and educational purposes only.

This form is not the official U.S. Department of State website and does not submit, save, or process an official DV Lottery entry. Official entries can be submitted only through dvprogram.state.gov during the official registration period.

Practice form only. This simulator does not submit an official Diversity Visa entry. Official entries are accepted only at dvprogram.state.gov.

Part One — Entrant Information

1. Full Name — Family Name First Name Middle Name 2. Date of Birth 3. Sex 4. City Where You Were Born 5. Country Where You Were Born 6. Country of Eligibility for the DV Program

Part Two — Entrant Photograph

7. Upload Photograph

JPEG image, 600 × 600 pixels, maximum 240 KB.

Part Three — Mailing Address

8. Mailing Address Address Line 2 City/Town State/Province Postal Code/ZIP Country

Part Four — Country Where You Live Today

9. Country Where You Live Today

Part Five — Phone and Email

10. Phone Number 11. Email Address Confirm Email Address

Part Six — Highest Level of Education

12. What is the highest level of education you have achieved, as of today?

Part Seven — Marital Status

13. Current Marital Status Number of Children

I understand this is a non-official practice simulator and no entry will be submitted.