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Registration Home >> Register Trip >> Short-Term Trip
Please Note: An asterisk (*) denotes a required field.
Registration Instructions
- Enter your name, contact information, and Date of Birth in the Personal Information section. You should have your passport ready if you would like to enter your Passport Information. - Your Emergency Contact should be someone who is not traveling with you. Remember to leave a detailed itinerary and the numbers of your passport or other citizenship documents with someone who is not traveling. - Add contact information about any Additional Travelers if you are traveling with one or more family members or companions. - Provide enough information about your travel destination to help a U.S. consular officer contact you in case of an emergency, including the dates you will be traveling (approximate dates are acceptable). Providing the hotel name, the city, and the country will be useful, even if you cannot provide the hotel phone number. If you are traveling to additional cities or countries, press the Add Additional Destination button to enter information about those destinations. - You will be asked to confirm that you have read the Privacy Act Notice. In accordance with the Privacy Act, information on your welfare and whereabouts may not be released without your express authorization.
Travel Registration
The Travel Registration service for American citizens allows you to register your contact information, including emergency contacts, through the Internet. The data you provide is encrypted and secure behind Department of State firewalls, and accessible only by authorized State Department personnel in Embassies, Consulates, and the Department of State in order to assist you. Should an emergency in your country arise, the Embassy will attempt to contact you immediately to advise you of the situation.
Paperwork Reduction Act Statement
Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time required for searching existing data sources, gathering the necessary documentation, providing the information or documents required, and reviewing the final collection. You do not have to supply this information unless this collection displays a valid Office of Management and Budget (OMB) number. If you have comments on the accuracy of this burden estimate or recommendations for reducing it, please send them to: Information Collection Coordinator, U.S. Department of State, A/RPS/DIR, Washington, DC 20520. OMB Approval No.: 1405-0152 Expiration Date: 10/31/2006 Estimated Burden: 10 minutes Form: DS-4024
Fill out your Personal Information. The following fields must be completed: First Name, Last Name, and Date of Birth. Additionally, you must include one form of contact information (Full Address, Email Address, Phone Number, or Fax Number ).
Personal Information: | TOP | BOTTOM
First Name*: | Middle Name: | Last Name*: | Suffix:
Address Line 1:
Address Line 2:
City:
U.S. State: | Foreign State/Province:
Postal Code: | Country:
Phone: | Fax:
Email Address: |
Date of Birth*: (e.g. 1977) | Gender:
Citizenship:
Comments: (limit 300 characters)
Passport Information: | TOP | BOTTOM
Passport Number: Passport Place of Issue (Authority):
Passport Date of Issue: (e.g. 2005) | Passport Date of Expiration: (e.g. 2005)
Fill out your Emergency Contact information. Your Emergency Contact should be someone who is not traveling with you. If you enter any information in this section then a First Name, Last Name, and one form of contact information is required (Full Address, Email Address, Phone Number, or Fax Number).
Emergency Contact Information: | TOP | BOTTOM
First Name: | Middle Name: | Last Name: | Suffix:
SAME AS ABOVE ADDRESS
Address Line 1:
Address Line 2:
City: |
U.S. State: | Foreign State/Province:
Postal Code: | Country:
Phone: | Fax:
Email Address:
Relationship to Primary Traveler: | Other Means of Contact:
Press the Add Additional Travelers button if you are traveling with one or more companions. The system will allow you to provide personal and contact information for each travel companion.
Additional Travelers: | TOP | BOTTOM
Please provide enough information about your Destination to help a U.S. consular officer contact you in case of an emergency. The following fields must be completed: Destination Date of Arrival, Destination Date of Departure, and Country.
Itinerary: | TOP | BOTTOM
Destination Date of Arrival*: (e.g. 2005) | Destination Date of Departure*: (e.g. 2005)
Purpose of Visit: (limit 200 characters)
Destination Information: | TOP | BOTTOM
Destination Type:

Address Line 1:

Address Line 2:

City: | Foreign State/Province:

Postal Code: | Country*:

Phone: | Fax:
Email Address:

Press the Add Additional Destination button if you are traveling to additional cities or countries. The system will allow you to provide details about your other destinations.
Additional Destination Information: | TOP | BOTTOM
Fill out your Privacy Act information. You must check the checkbox to indicate that you have read the Privacy Act Notice in order to continue to the next page.
Privacy Act Information: | TOP | BOTTOM
REGISTRATION AND PRIVACY:
The Department of State is committed to ensuring that any personal information received by our overseas embassies and consulates pursuant to the registration process, whether in person or otherwise, is safeguarded against unauthorized disclosure. The data that you provide the Department of State is subject to the provisions of the Privacy Act (5 USC 552a). This means that the Department of State will not disclose the information you provide us in your registration application to any third parties unless you have first given us written authorization to do so, or unless the disclosure is otherwise permitted by the Privacy Act. Authority: 22 U.S.C 2715, and 22 U.S.C 4802 (b). Purpose: To notify U.S. citizens in the event of a disaster, emergency or other crisis, and for evacuation coordination. The information solicited on this form may be made available as a routine use to appropriate agencies whether federal, state, local, or foreign, to assist the Department in the evacuation or provision of emergency service to U.S. citizens, or for law enforcement and administration purposes or pursuant to court order. The information is also made available to private U.S. citizens, known as wardens, designated by U.S. embassies to assist in communicating with the American community in an emergency. For a complete statement of the routine uses to which this information may be put, see the Prefatory Statement of Routine Uses and the listing of routine uses set forth in the systems description for Overseas Citizens Services Records (State-05), found at http://foia.state.gov/issuances/priviss.asp. Lastly, while this internet site uses secure encryption to safeguard your privacy and therefore any unauthorized interception by third parties of the information you send via the internet is unlikely, please keep in mind that the Department of State is not responsible for any such interception.
I have read the terms of the Privacy Act Notice*
I do not authorize the State Department to disclose my information to anyone except as authorized by law. I agree to allow the State Department to disclose my information to:
Family Members
Friends
Legal Representative
Media
Medical Representative
Members of Congress
Other
Waiver Comments: (Please use the space below to specify individuals, explain or clarify your response, or describe your selection of 'Other'. limit 200 characters)
When you have completed the Short-Term Trip form, press the Continue button to proceed to the Confirmation page.
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