ON-LINE REGISTRATION FORM:
Fill in all the below information.

Surname/Family Name:

  Other Name:

Date of Birth:
Day: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

 Month: January February March April May June July August September October November December

 Year: 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Place of Birth:
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Country:
Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas, The Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Cape Verde Central African Republic Chad Chile Comoros Congo Congo, Democratic Republic of the Costa Rica Cote D'Iviore (Ivory Coast) Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica East Timor Ecuador Egypt Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France France Reunion Gabon Gambia, The Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Honduras Hong Kong Special Administrative Region Hungary Iceland Indonesia Iran Iraq Ireland Israel Italy Japan Jordan Kazakstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau S.A.R. Macedonia, the Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Micronesia, Federated States of Moldova Monaco Mongolia Morocco Mozambique Namibia Nauru Nepal Netherlands Netherlands Antilles Netherlands Aruba New Zealand Nicaragua Niger Nigeria North Korea Northern Ireland Norway Oman Palau Panama Papua New Guinea Paraguay Peru Poland Portugal Qatar Romania Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates Uruguay Uzbekistan Vanuatu Vatican City Venezuela Yemen Yugoslavia, Federal Republic of Zambia Zimbabwe

MARITAL STATUS:  Single   Married   Divorced   Separated   Widow

ACADEMIC / PROFESSIONAL QUALIFICATION:High School  Elementary  Vocation (# of years )
                                                                          Undergraduate  Graduate  Post Graduate

SPOUSE:

Surname/Family Name:

   Other Name:

Date of Birth:
 Day: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

 Month: January February March April May June July August September October November December

 Year: 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Place of Birth:
City:

Country:
Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas, The Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Cape Verde Central African Republic Chad Chile Comoros Congo Congo, Democratic Republic of the Costa Rica Cote D'Iviore (Ivory Coast) Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica East Timor Ecuador Egypt Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France France Reunion Gabon Gambia, The Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Honduras Hong Kong Special Administrative Region Hungary Iceland Indonesia Iran Iraq Ireland Israel Italy Japan Jordan Kazakstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau S.A.R. Macedonia, the Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Micronesia, Federated States of Moldova Monaco Mongolia Morocco Mozambique Namibia Nauru Nepal Netherlands Netherlands Antilles Netherlands Aruba New Zealand Nicaragua Niger Nigeria North Korea Northern Ireland Norway Oman Palau Panama Papua New Guinea Paraguay Peru Poland Portugal Qatar Romania Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates Uruguay Uzbekistan Vanuatu Vatican City Venezuela Yemen Yugoslavia, Federal Republic of Zambia Zimbabwe

MAILING ADDRESS:

Name:
Address Line 1:
Address Line 2:
City:
District/State/Province:
Postal Code:
Country:	Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas, The Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Cape Verde Central African Republic Chad Chile Comoros Congo Congo, Democratic Republic of the Costa Rica Cote D'Iviore (Ivory Coast) Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica East Timor Ecuador Egypt Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France France Reunion Gabon Gambia, The Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Honduras Hong Kong Special Administrative Region Hungary Iceland Indonesia Iran Iraq Ireland Israel Italy Japan Jordan Kazakstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau S.A.R. Macedonia, the Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Micronesia, Federated States of Moldova Monaco Mongolia Morocco Mozambique Namibia Nauru Nepal Netherlands Netherlands Antilles Netherlands Aruba New Zealand Nicaragua Niger Nigeria North Korea Northern Ireland Norway Oman Palau Panama Papua New Guinea Paraguay Peru Poland Portugal Qatar Romania Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates Uruguay Uzbekistan Vanuatu Vatican City Venezuela Yemen Yugoslavia, Federal Republic of Zambia Zimbabwe
Telephone:
E-mail:

 

PHOTOGRAPHS REQUIRED: Size:  Between 1.5" X 1.5" (37mm X 37mm)and 2" X 2" (50mm X 50mm) If you have digital photos you can email them to us. Otherwise send by mail.

Rates:   (back)
The fee for preparing and submitting this application is $25 for every Application.

Select method of payment: (Payment must be made in U.S. dollars and made payable to:
The Global Lawyers.) 

Credit Card
Check drawn on a US Bank                
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International Money Order in US dollars
Foreign Postal Money Order in US dollars
US Money Order

Credit Card Information: VISA  MASTERCARD

Name and Address of Credit Card Owner. (This name must be the same as that of the Applicant, or Applicant's Spouse):

Credit Card Number:

Credit Expiration Date: Month January February March April May June July August September October November December Year 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021

Credit Card Security Code:

 Send payments to:
  Bowling Green Station
P.O. Box 349
New York, NY 10274 USA 

Make sure you have answered all questions. After reading and signing the below Retainer Agreement press the "Submit Form" button. A few seconds after submitting your registration the server will show you a confirmation page informing you that your registration details have reached us. You can now send your payment to the address above. You will be contacted once your payment has been received.

 

RETAINER AGREEMENT

In consideration of the services rendered to me by The Global Lawyers in respect of the filing of my D.V. Application to the appropriate Department, I hereby agree to pay a non-refundable processing fee of  $25 for every Application I submit or its equivalent in Pounds, Euro and Naira.

 

BY SUBMITTING THIS RETAINER, I HAVE ACKNOWLEDGED:

A. That this Law office has my authorization to process &  submit my EDV Lottery Application
      at a processing fee of $25 per entry.

B. That Soliciting for the Services of The Global Lawyers, in processing and electronically filing my
     EDV Lottery Application does not guarantee automatic success of my entry.
     But is simply aimed at enhancing my chances of  success.

C. That the terms and conditions of the services to be rendered to me by this Law Office as Contained above
     are acceptable and agreeable to me.

D. That I undertake to pay full service fees as prescribed by this Law Office in consideration of the assistance
      in processing and electronically filing my EDV Lottery Form           

Enter your full name and address and the date you are submitting this registration in the space below:
APPLICANT'S NAME:  
ADDRESS:
DATE:

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