Employment Information
Travel Information
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GE Membership
Do any of the following apply to you? (Change to Yes if
applicable)
Do you have a physical or mental disorder; or are you a drug abuser or addict; or do you
currently have any of the following diseases (communicable diseases are specified pursuant
to
section 361(b) of the Public Health Service Act):
- Cholera
- Difteria
- Infectious tuberculosis
- Plague
- Smallpox2
- Yellow fever Viral Hemorrhagic Fevers, including Ebola, Lassa, Marburg virus disease,
Crimean-Congo
- Severe acute respiratory illnesses capable of transmission to other persons and likely
to cause mortality
Have you ever been arrested or convicted for a crime that resulted in serious damage to
property, or serious harm to another person or government authority?
Have you ever violated any law related to possessing, using, or distributing illegal drugs?
Do you seek to engage in or have you ever engaged in terrorist activities, espionage,
sabotage, or genocide?
Have you ever committed fraud or misrepresented yourself or others to obtain, or assist
others to obtain, a visa or entry into the United States?
Are you currently seeking employment in the United States or were you previously employed in
the United States without prior permission from the U.S. government?
Have you ever been denied a U.S. visa you applied for with your current or previous passport,
or have you ever been refused admission to the United States or withdrawn your application
for admission at a U.S. port of entry?
Have you ever stayed in the United States longer than the admission period granted to you by
the U.S. government?
Have you traveled to, or been present in Iraq, Syria, Iran, Sudan, Libya, Somalia or Yemen on
or after March 1, 2011?