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Official Trusted Traveler Program Website - Department of Homeland Security
Official Trusted Traveler Program Website - Department of Homeland Security
Version: Draft
Note: You cannot make changes to an application once it is submitted. If you find errors, the Officer at the enrollment center will need
to change your application for you.
Please review each section, confirm your answers are correct, and then click Save & Continue to certify and pay.
1 Personal Info
Date of Birth:
Birth Feb 27, 1992
City of birth: Tampa
Country of birth: UNITED STATES
State/province of birth: FLORIDA
Identifying Characteristics
Gender: Male
Gender
Eye color:
color Bluish Green
Height: 5 ft 11 in
Height
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3/13/2020 Official Trusted Traveler Program Website | Department of Homeland Security
2 Documents
Your Citizenship
UNITED STATES
Surname/last name:
name WARNER
Given name:
name JOSHUA ANTHONY
Middle name:
name
Date of birth:
birth Feb 27, 1992
Country of issuance:
issuance UNITED STATES
Passport number:
number 477581182
Date of issue (issuance date):
date) Mar 21, 2011
Date of expiry (expiration date) Mar 20, 2021
You've entered 1 document proving you may enter the United States.
Surname/last name:
name WARNER
Given name:
name JOSHUA ANTHONY
Middle name:
name
Date of birth:
birth Feb 27, 1992
Country of issuance:
issuance UNITED STATES
Passport number:
number 477581182
Date of issue (issuance date):
date) Mar 21, 2011
Date of expiry (expiration date) Mar 20, 2021
3 Driver's License
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Driver's License
4 Vehicle Info
5 Address Info
You have provided the following addresses to meet the address history requirement:
Previous address:
address: Jan 2015-Dec 2018
Start date:
date Jan 2015
End date:
date Dec 2018
Address line 1:
1 109 E 4TH AVE 6
Address line 2:
2
City: CONSHOHOCKEN
City
State/province/region: PENNSYLVANIA
State/province/region
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3/13/2020 Official Trusted Traveler Program Website | Department of Homeland Security
Zip code/postal code:
code 194281980
Current address:
address: Jan 2019-Present
2019-Present
Start date:
date Jan 2019
Address line 1:
1 206 SUNSET LN
Address line 2:
2
City: LINCOLN UNIVERSITY
City
State/province/region: PENNSYLVANIA
State/province/region
Zip code/postal code:
code 193529001
6 Employment Info
You have provided the following employments to meet the employment history requirement:
Previous Employment
Employment Status:
Status Employed
What is your occupation?:
occupation? Outside Sales Rep
When did it begin?:
begin? Sep 2014
When did it end?:
end? Jan 2018
Who is your employer?:
employer? MSC Industrial Supply Co.
Previous Employment
Employment Status:
Status Employed
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What is your occupation?:
occupation? Meat and Seafood Department
When did it begin?:
begin? Jul 2014
When did it end?:
end? Sep 2014
Who is your employer?:
employer? Acme Markets
Previous Employment
Employment Status:
Status Employed
What is your occupation?:
occupation? Retail Sales
When did it begin?:
begin? May 2014
When did it end?:
end? Aug 2014
Who is your employer?:
employer? Radioshack
Previous Employment
Employment Status:
Status Employed
What is your occupation?:
occupation? Delivery Driver
When did it begin?:
begin? Mar 2014
When did it end?:
end? May 2014
Who is your employer?:
employer? Jimmy Johns
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What is your employer's phone number?
Phone number format:
format United States, Canada, +1
Phone number:
number 5733419009
Extension:
Extension
Previous Employment
Employment Status:
Status Employed
What is your occupation?:
occupation? Home Chef
When did it begin?:
begin? Aug 2013
When did it end?:
end? May 2014
Who is your employer?:
employer? Theta Xi Fraternity
Previous Employment
Employment Status:
Status Employed
What is your occupation?:
occupation? Skilled Maintenance
When did it begin?:
begin? May 2013
When did it end?:
end? Aug 2013
Who is your employer?:
employer? Missouri University of Science and Technology
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3/13/2020 Official Trusted Traveler Program Website | Department of Homeland Security
Where do you work?
Country: UNITED STATES
Country
Address line 1:
1 205 West 12th Street
Address line 2:
2
City: Rolla
City
State/province/region: PENNSYLVANIA
State/province/region
Zip code/postal code:
code 65401
Previous Employment
7 Travel History
Countries Visited
Have you traveled to countries other than the United States, Canada, and Mexico since March 2015?
Yes
Countries:
IRELAND
ITALY
GREECE
FRANCE
HONDURAS
BELIZE
8 Additional Info
Background Questions
Have you ever been convicted of a criminal offense in the United States or any other country?
No
Have you ever been arrested or had charges that were expunged or removed? If yes please describe.
Have you ever received a waiver of inadmissibility to the U.S. from a U.S. government agency?
No
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Have you ever been found in violation of customs laws?
No
No
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