NOLB Request for Assistance

NOLB Request for Assistance

This form is for any SIV holders, SIV applicants, or SIV eligible person and their family who wants to be evacuated from Afghanistan. Completing this form does not guarantee NOLB’s ability to aid or respond. THIS IS NOT A VISA APPLICATION. WE CANNOT PROCESS VISAS.
Please attach all documents at the end of the form before you submit
Full Name (Primary Applicant) *
Full Name (Primary Applicant) *

First Name Middle Name Last Name
Birth Date *

Month Day Year
Gender *
E-mail *
Visa Status *
Cell Phone # *
Whatsapp #
Visa #
SIV Case # - or KBL# if available
National ID #
Passport #
Current Location *

Street Address Line 2

Country
City *
U.S. contact or agency assisting you

Please include name and contact information 0/150
Who was your U.S. Government employer, and what was your job and duties?

0/150
Add Each Family Member Below

Please attach all documents at the end of the form
Family Member #1
Name

First Name Middle Name Last Name
Birth Date

Month Day Year
Gender
National ID #
Passport #
Visa #
Relationship to Primary Applicant
Family Member #2
Name

First Name Middle Name Last Name
Birth Date

Month Day Year
Gender
National ID #
Passport #
Visa #
Relationship to Primary Applicant
Family Member #3
Name

First Name Middle Name Last Name
Birth Date

Month Day Year
Gender
National ID #
Passport #
Visa #
Relationship to Primary Applicant
Family Member #4
Name

First Name Middle Name Last Name
Birth Date

Month Day Year
Gender
National ID #
Passport #
Visa #
Relationship to Primary Applicant
Family Member #5
Name

First Name Middle Name Last Name
Birth Date

Month Day Year
Gender
National ID #
Passport #
Visa #
Relationship to Primary Applicant
Family Member #6
Name

First Name Middle Name Last Name
Birth Date

Month Day Year
Gender
Passport #
National ID #
Visa #
Relationship to Primary Applicant
Family Member #7
Name

First Name Middle Name Last Name
Birth Date

Month Day Year
Gender
National ID #
Passport #
Visa #
Relationship to Primary Applicant
Family Member #8
First Name Middle Name Last Name
Birth Date

Month Day Year
Gender
National ID #
Passport #
Visa #
Relationship to Primary Applicant
Upload Passports

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Upload National IDs

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Upload Visas

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Should be Empty:

NOLB Request for Assistance

Please attach all documents at the end of the form before you submit

Add Each Family Member Below

Family Member #1

Family Member #2

Family Member #3

Family Member #4

Family Member #5

Family Member #6

Family Member #7

Family Member #8