• 01 Personal Information

  • Birth Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • State
  • Exp.Date (must be valid for six months after entry to Cuba)*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Gender*
  • 02 Contact Data

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • 03 Trip Information

    If not a U.S. citizen:
  • Exp.Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Please arrange my trip via:*
  • Pick State
  • Requested date of departure to/arrival in Havana
     - -
    2 digit month, 2 digit day, 4 digit year
  • Requested date of departure from Havana
     - -
    2 digit month, 2 digit day, 4 digit year
  • Hotel(s) Requested:
  • If not requesting hotel, please indicate address where you will be staying in Cuba:
  • Additional Requests:
  • Rules and Privacy Policy

  • Cuban Assets Control Regulations, 31 C.F.R. Part 515

  • Regulations / General License that Authorizes your Travel to Cuba:

  • Specific License Issued by The Office Of Foreign Assets Control Of The U.S. Treasury Department

  • Should be Empty: