Benin Tourist visa Application for citizens of Bangladesh living in Alberta

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1 VisaHQca Inc Benin Tourist visa pplication for citizens of Bangladesh living in lberta Please enter your contact information Name: Tel: Mobile: The latest date you need your passport returned in time for your travel: Benin tourist visa checklist Filled out and signed Benin 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 uthorization form, Certified Check, or Money Order payable to VisaHQca Return mailer Prepaid self-addressed return label or payment for FedEx If you wish to prepay return shipping, please add the shipping fee to the total and provide return address: FedEx 2nd day delivery - From $33 FedEx Priority Overnight - From $34 FedEx First Overnight - From $54 FedEx Saturday delivery - From $62 Prepaid self addressed mailer - $0 Local pick up in Ottawa - $0 Name: Company: ddress: City: State: Posta l code: * ctual prices may vary based on location per FedExcom VisaHQca Inc,, T: E: info@visahqca

2 VisaHQca Inc Proof of Status Copy of the front and back of valid Permanent Resident Card or other proof of legal status in Canada (such as study permit, work permit, refugee/protected person status document) Itinerary Copy of round trip tickets or itinerary Yellow Fever Vaccination 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 Health Canada's yellow fever resource centre VisaHQca Inc,, T: E: info@visahqca

3 VisaHQca Inc Benin tourist visa fees for citizens of Bangladesh living in lberta Type of visa Validity Processing time Embassy fee Service fee HST Total Single Entry up to 90 days 5 business days $12000 $6900 $345 $19245 Single Entry up to 90 days 2-3 business days $14500 $9900 $495 $24895 Multiple Entry up to 90 days 5 business days $14000 $6900 $345 $21245 Multiple Entry up to 90 days 2-3 business days $16500 $9900 $495 $26895 This order is subject to Terms of Service, posted on VisaHQ website ll fees and requirements may change without notice VisaHQca Inc,, T: E: info@visahqca

4 VisaHQca Inc Credit card authorization form By signing this form i accept VisaHQca Terms of Service and authorize to charge my credit card for the amount of $ Name on the Credit Card: Credit card number: Exp date: / CVC: Credit Card Billing ddress: Signature: Comments: Thank you! We accept all major credit cards VisaHQca Inc,, T: E: info@visahqca

5 République du Benin Protégé une fois rempli Republic of Beninn Protected when completed mbassade à Ottawa (Canada) Page 1 of/de 1 ESPCE RESERVEE DO NOT WRITE IN THIS SPCE DEMNDE DE VIS D ENTREE EN REPUBLIQUE DU BENINN PPLICT TION FOR VIS ENTRY IN BENIN REPUBLIC I want service in : English French File - Référence Je veux être servie en : nglais Français 1 Visas pour un seul séjour demandé Single entry visas requested Visas pour entrées multiple Multiple entry visa requested Visas de transit demandés Transit visas requested Photo 2 PPLICNT DEMNDEUR Nom de famille Family name Prénom First name utre prénom Second name Sexe Sex Date de naissance Date of birth Lieu de naissance Place of birth Etat matrimonial Marital Statut dresse au Canada dress in Canada Citoyenneté Citizenship Pays de résidence Country of residencee utre nationalité Other nationality Statut/ /Refugiés Oui/Yes Non/No Pays d origine Country Situation militaire Military status Profession Occupation Nom et adresse de mon employeur actuel ou de l Etablissement d enseignement Name and adress of my present employer or school 3 Passeport Passport Ordinaire Diplomatique Refugié Officiel No de Passeport Passport no Date d expiration Expiry date 4 Objet de ma visite au Benin - The purpose of my visite to Benin Tourisme ffaires Conférence Tourism Businesss Meeting utre Préciser ci-dessous Other Provide detail bellow 5 Veuillez indiquer pour combien de temps vous planifiez de rester au Bénin Please, Indicate how long you plan to stay in Benin De From To 6 S il s agit d un voyage d affaires, d une prospection de marché, avez-vous l adresse exacte d un contact au Bénin Have you any relations in Benin for business or do you intend to establish a factory in Benin? (Si oui veuillez indiquer le nom et les coordonnées de votre contact) ( If Yes, please give name and full address) Oui Yes Non No 7 Veuillez indiquer pour combien de temps vous planifiez de rester au Bénin Please, Indicate how long you plan to stay in Benin De From To Est-ce que vous-même ou tout membre de votre famille : vez séjourné au Bénin par le passé? Oui Non Si oui, dans quelle période? De Courriel Numéro de téléphone Numéro de télécopieur Telephone Number Fax Number 7 Je déclare avoir donné des réponsess exactes et complètes a toutes les questions de la présente demande/ I declare that I have answered all questions in this application fully and truthfully Signature Date :

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