17. List all educational institutions you attend or have attended. Include vocational institutions but not elementary schools.
16. Have you ever been in an armed conflict, either as a participant or victim?
Dates of Attendance
(mm-dd-yyyy) or "Present"
From
To
12. Not Including Current Employer, List Your Last Two Employers
Dates of Employment
(mm-dd-yyyy) or "Present"
Name
PLEASE TYPE OR PRINT YOUR ANSWERS IN THE SPACE PROVIDED BELOW EACH ITEM
PLEASE ATTACH AN ADDITIONAL SHEET IF YOU NEED MORE SPACE TO CONTINUE YOUR ANSWERS
U.S. Department of State
SUPPLEMENTAL NONIMMIGRANT VISA APPLICATION
15. Have you ever performed military service?
DS-157
01-2009
Approved OMB 1405-0134
Expires 11/30/2011
Estimated Burden 1 Hour*
1. Last Name(s) (List all Spellings) 2. First Name(s) (List all Spellings) 3. Full Name (In Native Alphabet)
If yes, complete below.
18. Have you made specific travel arrangements?
If YES, please provide a complete itinerary for your travel, including arrival/departure
dates, flight information, specific location you will visit, and a point of contact at each
location.
Yes
No
Course of Study
Name of Institution Address/Telephone Number
4. Clan or Tribe Name (If Applicable) 5. Spouse's Full Name (If Married)
6. Father's Full Name 7. Mother's Full Name
11. Have you ever lost a
passport or had one
stolen?
Yes
No
If YES, please explain.
Yes
No
Yes
No
Paperwork Reduction Act Statement
Public reporting burden for this collection of information is estimated to average 1 hour per response, including time required for searching existing data sources, gathering the necessary documentation, providing
the information and/or documents required, and reviewing the final collection. You do not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments
on the accuracy of this burden estimate and/or recommendations for reducing it, please send them to: A/ISS/DIR, Room 2400 SA-22, U.S. Department of State, Washington, DC 20522-2202
If YES, please explain
Yes
No
Dates of Service
(mm-dd-yyyy) or "Present"
From
To
Name of Country Branch of Service
Rank/Position
Military Specialty
8. Full Name and Address of Contact Person or Organization in the United States (Include Telephone Number)
9. List All Countries You have Entered in the Last Ten Years
(Give the Year of Each Visit)
10. List All Countries That Have Ever Issued You a
Passport
13. List all Professional, Social and Charitable Organizations to Which You Belong
(Belonged) or Contribute (Contributed) or with Which You Work (Have Worked).
14. Do you have any specialized skills or training, including firearms,
explosives, nuclear, biological, or chemical experience?
Address
Telephone Number Job Title Supervisor's Name From To
