14. Do you have any specialized skills or training, including firearms,
explosives, nuclear, biological, or chemical experience?
12. Not Including Current Employer, List Your Last Two Employers
9. List All Countries You have Entered in the Last Ten Years
(Give the Year of Each Visit)
Telephone Number
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
04-2006
Approved OMB 1405-0134
Expires 09/30/2008
Estimated Burden 1 Hour*
1. Last Name(s) (List all Spellings) 2. First Name(s) (List all Spellings) 3. Full Name (In Native Alphabet)
16. Have you ever been in an armed conflict, either as a participant or victim?
13. List all Professional, Social and Charitable Organizations to Which You
Belong (Belonged) or Contribute (Contributed) or with Which You Work
(Have Worked).
If yes, give name of country, branch of service, rank/position, military specialty, and dates
of service.
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
Dates of Attendance
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?
8. Full Name and Address of Contact Person or Organization in the United States (Include Telephone Number)
10. List All Countries That Have Ever Issued You a
Passport
Yes
No
If YES, please explain.
Yes
No
Yes
No
Address
Job Title
Supervisor's Name
Dates of Employment
17. List all educational institutions you attend or have attended. Include vocational institutions but not elementary schools.
Name
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 data, providing the information required, and reviewing the final collection. You do not have to provide the information unless this collection displays a currently valid OMB
number. Send comments on the accuracy of this estimate of the burden and recommendations for reducing it to: U.S. Department of State, A/RPS/DIR, Washington, DC 20520
.
If YES, please explain
Yes
No
Elena Di
222 SW 27 Drive, Weston, FL 33484 USA
(954)777-8855
Lawlogix Group, Inc. DS-157
