Internet Store and Ecommerce Solution Provider - Free Web Site - Free Web Space and Site Hosting - Web Hosting - High Speed Internet
Search the Web

اللوترى الامريكى
الخدمات التجارية لشبكة بوابة السودان
الخدمات التجارية

تصميم مواقع

الاعلانات

باقات ورد

خدمات من السودان

الدراسة والاقامة فى كندا

Services In English

This application is NOT FREE.
Applications with Non-Payment will not be processed

1

COMPLETE & SUBMIT the form below. If you are filing a dual application, complete 2 applications, one for each spouse.

2

PRINT & SIGN the resulting application (2 pages). If you are unable to print the application, provide the required information on a sheet of paper.

3

MAIL your application, photograph, and processing fee to Sudan Gate.Or proceed to pay online by credit card.
DV-2003 APPLICATION
APPLICANT
Name

First Name

Middle Name 
Last Name
Birth Date

Day

Month

Year

Birth Place

City/Town

Province/State 
Country
Country  Claimed
SPOUSE
Name

First Name 

Middle Name 
Last Name
Birth Date

Day 

Month 
Year
Birth Place

City/Town 

Province/State 
Country
CHILD #1
Name

First Name 

Middle Name 
Last Name
Birth Date

Day 

Month 
Year
Birth Place

City/Town

Province/State
Country
CHILD #2
Name

First Name 

Middle Name 
Last Name
Birth Date

Day
 

Month
Year
Birth Place

City/Town

Province/State 
Country
ADDITIONAL INFORMATION

List additional children and/or provide an explanation for claiming nativity in a country other than your country of birth:

CONTACT INFORMATION
Address Address Line 1
Address Line 2
City/Town
Province/State
Postal Code
Country
Telephone
Email
 IMPORTANT NOTICE
THIS PAYMENT IS UNREFUNDABLE
By submitting this form, you agree to pay Sudan Gate for services related to the preparation and submission of your Diversity Immigrant Visa ("Green Card") Lottery application. You further acknowledge that Sudan Gate does not guarantee that you will receive a permanent US residence/work visa, but only provides you with an opportunity to participate in the Green Card Lottery. Because this is a lottery, you cannot claim a refund for fees paid to process your application.  If you accept these terms, please proceed by clicking Submit, below.


Sudan Gate
159 Mohawk Rd.E
Hamilton,Ontario, L9A 2H4
Canada