Passport Appointment Request

Please fill out this form to request an appointment to have your passport application processed. An agent will be in touch with you to confirm the next available appointment date and time. Please note that we typically book appointments about three weeks in advance.

Applicant Name(s)

Applicant Name(s)
	Applicant Name(s) First Name Last Name	Item weight

more items

Parent Name (for Minor Applicants only)

Phone Number

Email Address:

Number of Adults (Ages 18+) Applying for Passport

Number of Minors (Ages 16-17) Applying for Passport

Number of Minors (Ages 15 and below) Applying for Passport

Have any applicants had a passport book previously? If yes, when was the passport book issued?

IF a Minor (Ages 15 and below) is Applying- Will BOTH/ALL Parents be Present?

Yes

No, but we will bring the notarized DS-3505 form and a color copy of the absent parent's ID

My situation is different and I need further assistance

Other…

Will the Passport Application need to be expedited? (additional $60 fee)

Yes

Unsure

Do you have the following documents?

DS-11 Form (NOT signed and completed in black ink)

Valid ID (copies can be made at the library)

Passport Photo

Original Birth Certificate

Other…

Are your documents in a language other than English?

Yes

What method will you use to pay for the fees to the Lindenhurst Memorial Library?

Please note the library charges a $35 execution fee for each application.

Card

Cash

Check

What method will you use to pay for the fees to the Department of State?

Please note the Department of State only accepts checks or money orders. Checks can be written at the time of the appointment after the final price has been verified by the Acceptance Agent. For further information on Department of State fees please go to: https://travel.state.gov/content/travel/en/passports/how-apply/fees.html

Check

Money Order

Which day(s) would you prefer to have your appointment?

After we receive your request for an appointment, an agent will call you to confirm the time and date. We are currently offering appointment times on Monday and Thursday afternoons and Monday and Tuesday evenings.

Monday Afternoon

Monday Evening

Tuesday Evening

Thursday Afternoon

Are there any language or accessibility needs that you would like us to be aware of?

Are there any additional questions you have for us before your passport appointment?

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.