1. Confirmation Number:
In the space below, type the confirmation number that was given when you applied.
2. Last/Family Name:
Provide the Last/Family Name that was used on the Electronic Diversity Visa Entry Form, including punctuation.
3. Year of Birth:
Provide the year of birth for the primary entrant.
4. Authentication
Type the characters as they appear in the picture.
Change the CAPTCHA codeSpeak the CAPTCHA code