Burkina Faso Tourist visa Application

Transcription

1 Burkina Faso Tourist visa Application Please enter your contact information Name: Tel: Mobile: The latest date you need your passport returned in time for your travel: Burkina Faso tourist visa checklist Filled out and signed Burkina Faso tourist visa application form. The form is enclosed. Original Passport. Passport must have at least 6 months remaining validity and have at least 1 visa page. 2 Photographs. Standard passport photographs 2x2 inches on a white background. Payment. Credit Card Authorization form, Certified Check, or Money Order payable to VisaHQ.com. Return mailer. Prepaid self-addressed return label or payment for FedEx. Proof of status. Copy of Green Card (both sides) or other proof of legal status in the US (such as copy of I-20, US visa, H1B approval notice, etc. VisaHQ cannot assist US B1/B2 visa holders at this time.) Yellow Fever Vaccination. A copy of the International Certificate of Vaccination (ICV) for yellow fever. To learn more about the yellow fever vaccination or to locate a vaccination clinic, please visit the CDC's yellow fever resource page.

2 If you wish to prepay return shipping, please add the shipping fee to the total and provide return address: FedEx 2nd day delivery - From $16 FedEx Standard Overnight - From $22 FedEx Priority Overnight - From $26 FedEx First Overnight - From $55 FedEx Saturday delivery - From $60 Prepaid self addressed mailer - $0 Local pick up in Washington - $0 Name: Company: Address: City: State: Zip: * Actual prices may vary based on location per FedEx.com.

3 Burkina Faso tourist visa fees for citizens of France living in Alabama Type of visa Validity Processing time Embassy fee Service fee Total Multiple entry up to 180 days 3 business days $ $99.00 $ Multiple entry up to 180 days Next business day $ $ $ Multiple entry up to 365 days 3 business days $ $99.00 $ Multiple entry up to 365 days Next business day $ $ $ This order is subject to Terms of Service, posted on VisaHQ website. All fees and requirements may change without notice.

4 Credit card authorization form By signing this form i accept VisaHQ.com Terms of Service and authorize to charge my credit card for the amount of $ Name on the Credit Card: Credit card number: Exp. date: / Credit Card Billing Address: Signature: Comments: Thank you! We accept all major credit cards.

5 Nom (en lettre capitale) :... Name Née (Nom de jeune fille) : Maiden name Prénoms : Given names AMBASSADE DU BURKINA FASO A WASHINGTON D.C Massachusetts Ave, D.C Washington, D.C USA tél: (202) fax: (202) DEMANDE DE VISA DE TRANSIT OU DE SEJOUR AU BURKINA FASO N /AMBF/WASH Informations du demandeur du / / Né(e) le :. /. /.. (JJ/MM/AAAA) à.... Sexe : M Date of birth (dd/mm/yyyy) Photographie Nationalité d'origine : Nationality of origin Nationalité actuelle :. Nationality Situation de famille : Nombre d'enfants : Relationship status Adresse du demandeur :.. Address Contact :.. Phone number Profession :... Occupation Place of birth Number of children Sex F Informations Visa Transit Transit à destination de : date d arrivée : / / Going to Arrival date Séjours durée du séjour :. Nombre d entrées : Une Multiples Stay Length of the stay Number of entrance Motif du voyage : Type du visa:.. Purpose of travel... Lieu(x) de destination :.. Destination..... Adresse au Burkina Faso :..... Address in Burkina Contact :..... Phone number Informations Passeport N du passeport :.. Date d'expiration :. /. /.. (JJ/MM/AAAA) Passport number Délivré le :. /. /.. (JJ/MM/AAAA) Validity date (dd/mm/yyyy) Issued date (dd/mm/yyyy) Place of issue par :. Fait à, Le. /. /.. (JJ/MM/AAAA) At Signature du demandeur Signature