Global Entry Application Form

PERSONAL INFORMATION

You are: *

First Time Global Entry Applicant

Renewal Global Entry Applicant (Please provide PASS ID or GOES User ID) Renewal Global Entry Applicant (Please provide PASS ID or GOES User ID)

Last Name *

First Name *

Middle Name

Other Name

Date of Birth * +

Country of Birth *

State of Birth *

City of Birth *

Gender *

Male

Female

Height *

Eye colour *

CONTACT INFORMATION

Email Address *

Please confirm your email *

Mobile Phone

Home Phone

CITIZENSHIP & NATIONALITY INFORMATION

You are: *

US CITIZEN

US PERMANENT RESIDENT

MEXICAN CITIZEN

Other Other

PASSPORT NUMBER *

COUNTRY OF ISSUANCE *

DATE OF ISSUE yyyy/mm/dd +

DATE OF EXPIRY yyyy/mm/dd * +

EXACT NAME ON PASSPORT *

IF you are not US citizen, please fill the fields below:

VISA OR PR CARD NUMBER

TYPE OF DOCUMENT

COUNTRY OF ISSUANCE

DATE OF EXPIRY yyyy/mm/dd +

EXACT NAME ON VISA OR PR CARD

MEXICAN CITIZENS MUST PROVIDE:

RFC (REGISTRO FEDERAL DE CONTRIBUYENTES): *

IS THIS RFC OWNED BY THE APPLICANT? *

Yes

No

CURP: *

US Contact FULL NAME: *

AS OF DATE: YYYY/MM *

Address line *

City *

State *

ZIP code *

PHONE NUMBER *

DRIVER'S LICENCE INFORMATION

DRIVER'S LICENCE NUMBER *

DATE OF EXPIRY yyyy/mm/dd * +

COUNTRY OF ISSUANCE *

STATE OF ISSUANCE *

EXACT NAME ON DRIVER LICENSE *

Additional information

CHECK HERE IF THIS IS AN ENHANCED DRIVERS LICENCE /EDL/

CHECK HERE IF THIS IS A COMMERCIAL DRIVERS LICENCE /CDL/

CHECK HERE IF THERE IS HAZMAT ENDORSEMENT ON THE CDL

VEHICLE REGISTRATION

A vehicle must be registered before it can be used in the SENTRI lanes (dedicated vehicle lanes for preapproved, low-risk travelers) to enter the United States from Mexico. Global Entry, SENTRI, and NEXUS members may use registered vehicles in the SENTRI lanes.

Do you plan to drive across the border from Mexico to the United States? *

Yes

No

Is the vehicle already actively registered on your account or n another Trusted Traveler Program member's account? *

Yes

No

Do you want to register the vehicle now? Note that registering it later will incur additional fees! *

Yes

No

CAR MAKE *

MODEL *

YEAR *

LICENCE PLATE NUMBER *

VIN NUMBER *

STATE WHERE LICENCE PLATE WAS ISSUED *

OWNER NAME *

OWNER ADDRESS *

CITY *

STATE *

ZIP CODE *

OWNER`S PHONE NUMBER *

ADDRESS HISTORY FOR THE LAST 5 YEARS

When did you start living from here? (Month/Year) * *

Address line 1 *

Address line 2

City *

State *

Country *

ZIP code *

Have you lived at your address less than 5 years? * 🛈

Yes

No

FROM YYYY/MM

TO YYYY/MM

Address line 1

Address line 2

City

State

Country

ZIP code

Is your mailing addres the same as your current address? * 🛈

Yes

No

From? (Month/Year) *

Address line 1

Address line 2

City

State

Country

ZIP code

EMPLOYMENT HISTORY FOR THE LAST 5 YEARS

EMPLOYMENT STATUS *

From? (Month/Year) *

JOB TITLE *

CURRENT EMPLOYER *

ADDRESS

EMPLOYER'S PHONE

CITY

STATE

COUNTRY

ZIP code

DO YOU HAVE EMPLOYMENT HISTORY? *

YES

NO

EMPLOYMENT STATUS *

FROM (Month/Year) *

TO (Month/Year) *

JOB TITLE *

EMPLOYER *

ADDRESS

EMPLOYER'S PHONE

CITY

STATE

COUNTRY

ZIP code

TRAVEL HISTORY

Please list all the countries you have traveled to in the last 5 years besides Canada, USA and Mexico. *

ADDITIONAL INFORMATION

Have you ever been convicted of a criminal offense (including misdemeanor or felony traffic violations) in the USA or any other country? *

Yes

No

IF YOU HAVE ANSWERED YES OF THE ABOVE QUESTION PLEASE GIVE EXACT DETAILS BELOW: *

Have you ever received a waiver of inadmissibility to the USA from a US government agency? *

Yes

No

IF YOU HAVE ANSWERED YES OF THE ABOVE QUESTION PLEASE GIVE EXACT DETAILS BELOW: *

Have you ever been in violation of US customs laws? *

Yes

No

IF YOU HAVE ANSWERED YES OF THE ABOVE QUESTION PLEASE GIVE EXACT DETAILS BELOW: *

Have you ever been found in violation of immigration laws? *

Yes

No

IF YOU HAVE ANSWERED YES OF THE ABOVE QUESTION PLEASE GIVE EXACT DETAILS BELOW: *

CREDIT CARD DETAILS

Your card details are needed to pay the additional $100 for background and security checks. Your application will not be processed without this. *

I agree to be charged $100 CBP fee for background and security checks

I understand that the government fee is non-refundable

NAME ON CARD *

BILLING ADDRESS *

CREDIT CARD NUMBER *

CCV * 🛈

EXPIRATION DATE *

DISCLAIMER

By submitting an application and paying our service fee, I agree with the following:

1. I understand that the website www.global-entry.app is not part of a government agency but a private company.
2. GLOBAL ENTRY card will cost you $169.95 service fee plus $120 government fee for background and security checks. You need to pay the first fee $169.95 through Revolut to start this process. Once your application is submitted, we will provide you government fee payment receipt.

3. global-entry.app is not responsible for applicants who are denied by CBP and will not refund the fees paid.

I CONFIRM THAT THE INFORMATION PROVIDED ON THIS FORM IS CORRECT AND ACCURATE TO THE BEST OF MY KNOWLEDGE. By signing below and paying the service fee I agree and understand global-entry.app's Terms of Use and Refund Policy described on their website: global-entry.app

*

Agree

Disagree

SIGNATURE *

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