Expedited Business/Student Visa Interview Request Form

Before you fill out the interview request form, please complete and print an EVAF DS-156 form. Please complete a separate application for each person (including children of any age) applying for a visa.

Last Name Required First Name Required Date of Birth (mm/dd/yyyy) Required Date of Interview Received at the Call Center Required Planned Date of Travel (mm/dd/yyyy)   Contact Information Telephone in Ukraine (Required) E-Mail (Required) Purpose of travel (Required) business trip business negotiations to attend seminar/conference training academic study professional exchange offical/diplomatic travel medical/humanitarian emergency other Electronic Visa Application Form (EVAF) Code: (Required. The number is found above the bar code on page three of the form and consists of 10 characters.) Check here if you have a visa expired during last 12 months. Check here if you have been denied a U.S. visa during last 12 months. What was the date of your last U.S. visa interview? (mm/dd/yyyy)   Additional Comments Justification of urgent travel: Scanned document (see above): (DOC,RTF,PDF,JPG,TIF, up to 2Mbytes.) I hereby acknowledge that the information above is correct.