FEDERAL REPUBLIC OF NIGERIA VISA APPLICATION FORM

[Pages:5]FEDERAL REPUBLIC OF NIGERIA

VISA APPLICATION FORM

NOTE:

i) ii)

Please complete the form in black ink and tick the boxes Short stay applicants must complete all the questions on

which apply this form

I J

iii)

Temporary employment applicants to omit questions 22 - 26, and 28

iv)

For diplomatic passport holders, questions 19 - 20, 24 - 25 are not applicable

PASSPORT PHOTO

PLEASE SEND WITH THIS FORM:

i)

The original letter of invitation from Nigeria/Diplomatic Note Verbale

ii)

One passporr-sized photograph (not more than sir months old) and

iii)

Your current passport with at least 6 months validity

iv)

A letter from your employer/sponsor(not applicable to diplomats)

C$ `A Separate form should be completed by every person intending to travel including children endorsed on their

parent'5 Passports.

1) Reason for travelling to Nigeria (please tick appropriate boxes)

a) Short Stay:

Visitor c l

Private

Official :

Business 0

q Student

Diplomatic 0

Other

q

,(Please

specify)

,

q Type of entry clearance required Transit 0 Single Entry 0 Double Entry0 Multiple Entry

b) Long Stay:

Temporary Employment: Work permit by Nigerian immigration authorities

cl

Accompanying spouse

cl

2) Full Name (as written in your passport)

I

I

3) Other Names used now or in the past (eg name before marriage)

I 4) Date of Birth

5) Sex

male female 1

6) Town and Country of Birth

7) Your Father's Full Name

8) Your Mother's Full Name

CGJHBFGP 01.1832

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9) Passport or Travel Issuing government/authority Document Details

Number

Nationality as shown in passport

I II

Document type (eg ordinary passport)

Date of Issue Valid Until Place of issue Day Month Year Day Month Year

IIjII If you are not travelling on your own passport give the following details:

Name of passport holder

Your relationship to passport holder

II

Is this your first passport? If not please provide details of previous passport(s)

L5El

Number

Date and Place of Issue

II Only complete this section if dependants included on your passport are travelling with you.

Full name of dependant

Place of birth Date of birth Relationship to Yourself

Nationality

10) Occupation

11) Place of work

12) What is your

Present address? 13) Please give your permanent address if different from above

14) Are you? Married 0 Single 0 Divorced 0 Widowed 0 Separated 0

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15) If married, please give details of spouse

Full name of spouse

Date of birth day month year

II

Where is your spouse now?

Where is your spouse normally resident?

16) Have you applied to go to Nigeria before?

If so, please give dates and places of application

17) Have you visited Nigeria before?

If so, please give dates and lengths of each stay

18) 4 Have you ever been refused a visa or entry clearance

at a Nigerian diplomatic mission or Post?

b) Have you ever been refused leave to enter on

arrival in Nigeria?

4 Have you ever been deported, removed or otherwise

required to leave Nigeria?

4 Have you ever been refused a visa for another country?

I Yes

I

[j Yes

4 Have you ever been deported from another country?

f) Have you ever been served with notice of illegal entry

or intention to deport from Nigeria?

g) Have you ever worked in Nigeria?

h) Do you have any criminal convictions in Nigeria

or elsewhere? (excluding any spent convictions)

19) Country of normal residence

Residence Permit number (if any)

Date of Issue Day Month Year

Valid until Day Month Year

20) Re-entry Visa (if applicable)

Visa Number

Date of Issue Day Month Year

Valid until Day Month Year

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21) How long do you intend

to stay in Nigeria?

I

22) What is your proposed date of arrival in Nigeria?

23) How will you travel to Nigeria?

I

Day Month Year 1

24) Have you bought your ticket already

If yes attach photocopy

Status

25) How much money is available to you during your stay?

(Evidence of this may be required) a) From your own sources

b) From other sources

26) Where will you stay

Please give details of host/sponsor/contact address

in Nigeria?

If you are staying in a hotel give its name and address

(It is not enough to say c/o Embassy or High Commission)

Full name of sponsor/contact address/hotel

Nationality of sponsor

I1 Address

Telephone Number

Resident in Nigeria since

Occupation

Relationship to you

Do you have any relatives or friends in Nigeria? I/ /I

27) Is your visit for business or official reasons?

If so, give name of Nigerian company/organisation to be visited

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l

This section must be read and signed by all applicants

a= An entry clearance can be a Visa, Entry Certificate or a Letter of Consent.

c#= Even if you hold a valid entry clearance you can still be refused entry into Nigeria by an Immigration Officer if he is satisfied that:

a) your entry clearance was obtained by false representations or by concealment of relevant facts, whether or not you knew of these actions; or

b) a change in circumstances between the date of your application and your arrival in Nigeria invalidates your entry clearance; or a refusal is justified on the grounds of restricted returnability, medical grounds, criminal records, because you are subject to a deportation order, or your exclusion would be conducive to the public good.

@= An Immigration Officer can ask anyone to be medically examined on arrival in Nigeria, if he considers it

necessary.

Please attach your photograph here

DECLARATION *I have read and understood the notes above *I declare that the information given in this application is

correct to the best of my knowledge and belief

Signed

Date

Visa type

Visa No.

I

For office use only I

Approved period of stay: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .._ ._... . . .._.._ . . . . . . . . . . . . . . . . . . . . . . . . Date: ............................................................................................................................................................ Signature: ..................................................................................................................................................... Comments: ................................................................................................................................................. ,..__.......................................................................................,...................................................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..~.............................................

Please attach an extra sheet of paper for additional notes

Fee: (amount) Document seen:

I Paid/Gratis

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