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2. Appointments are for groups of 3 or more applicants only.

   To request an appointment for passport application processing, please complete the below information. If you need assistance please contact us at 847-377-3351. Once your appointment has been confirmed an agent will contact you with instructions and requirements for your appointment.

4. Appointment Information

   Please enter the name and contact information for the person requesting the appointment. If you are requesting an appointment for a minor please enter the parent/guardian name.

6. Email
8. First Name
9. Phone Number
11. Last Name
12. Email
14. How many people will be applying for a passport?
    -- Select One --345678910 or more
16. Are any of the applicants 15 years of age or younger?

    1. No, all applicants are 16 years or older
    2. Yes
18. How many applicants 15 years or younger?

20. If an applicant is 15 or younger, both parents must be present. If both parents cannot be present, the Statement of Consent for Issuing a Passport to a Child (Form DS-3053) must be completed and brought to the appointment along with the application Form DS-11.

22. Application Information

    Please read the application descriptions and indicate the number of each type of application you will need processed at your appointment:

24. New Application

    Select this option if you have never had a passport before or your passport has expired for 10 years or more. Individuals aged 15 or younger will be required to fill out a new passport application when renewing their passport - Application for US Passport (Form DS-11)

26. Total Number of New Applications
    -- Select One --01234 or more
28. Renewal

    Select this option if you were previously issued a passport and meet all of the requirements for renewing your passport. Please visit see Passport Renewal information to see if you are eligible for this option. The option is not available for individuals 15 years or younger - Renewal Application (Form DS-82)

30. Total Number of Passport Renewals
    -- Select One --01234 or more
32. Lost or Stolen Passport

    Select this option if your current passport has been lost or stolen. Two forms will be required - Application for US Passport (Form DS-11) and Reporting Your Valid Passport Lost or Stolen (Form DS-64)

34. Number of Lost or Stolen Passports
    -- Select One --0123 or more
36. Passport Correcton/Change

    Select this option if you currently have a valid passport but must update the information that appears on your current passport, such as your name or gender - Data Corrections, Some Name Changes, and Limited-Validity Passports ( Form DS-5504)

38. Number of Passport Corrections or Changes
    -- Select One --0123 or more
40. Appointment Request

    Appointments are Monday through Friday from 8:30 AM to 1:30 PM. The last application is accepted at 1:00 PM. We will do our best to accommodate your request, but dates and times are subject to availability. Please allow a minimum of 30 minutes per application.

    Please enter a date and time at which you would like to come in. One of our agents will check availability and get back to you.

42. Preferred Date:
    Preferred Date:

    MM/DD/YYY (Monday through Friday)

43. Select a preferred time:
    Select a preferred time:

    HH:MM AM/PM (Frist time 8:30 AM and last selection at 1:00 PM)

    
    

45. If the requested date and/or time is unavailable, reschdule my appointment for:

    1. Same date different time
    2. Same time different date
    3. Next available date and time
    4. Contact me to discuss available dates and times
47. ¿hablas español?

    1. Necesito un intérprete español
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49. 1. Receive an email copy of this form.
50. Email address

    This field is not part of the form submission.

51. Submit

* indicates a required field