Federal republic of nigeria visa application form

FEDERAL REPUBLIC OF NIGERIA
VISA APPLICATION FORM
NOTE:
i) Please complete the form in black ink and tick the boxes which apply
I J
ii) Short stay applicants must complete all the questions on this form
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
Student q Diplomatic 0
Other q ,(Please specify) ,
Type of entry clearance required
Transit 0 Single Entry 0 Double Entry0 Multiple Entry q
b) Long Stay: Temporary Employment:
2) Full Name (as written in your passport)
Work permit by Nigerian immigration authorities
Accompanying spouse
cl
cl
I
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3)
Other Names used now or in the past (eg name before marriage)
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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

No. 2
9) Passport or Travel Issuing government/authority Number Nationality as shown in passport
Document Details
I
II
Document type Date of Issue Valid Until
(eg ordinary passport) 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)
Number
Date and Place of Issue
L5El
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 Nationality
Yourself
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

No. 3
15) If married, please Full name of spouse Date of birth
give details of spouse
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?
I Yes I
[ j Yes
4 Have you ever been refused a visa for another country?
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

No. 4
21)
22)
How long do you intend
to stay in Nigeria?
What is your proposed date of arrival in Nigeria?
23) How will you travel to Nigeria?
I
I
Day Month Year
1
24) Have you bought
your ticket already
If yes attach photocopy
Status
25) How much money
available to you
during your stay?
is
(Evidence of this may be required)
a) From your own sources
b) From other sources
26) Where will you stay
in Nigeria?
Full name of sponsor/contact address/hotel
Please give details of host/sponsor/contact address
If you are staying in a hotel give its name and address
(It is not enough to say c/o Embassy or High Commission)
Nationality of sponsor
I1
Address
Telephone Number Resident in Nigeria since Occupation
Relationship to you
Do you have any relatives or friends in Nigeria?
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27) Is your visit for business
or official reasons?
If so, give name of Nigerian company/organisation to be visited

No. 5
• 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
For office use only
Visa No. I I
Approved period of stay: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .._ ._... . . .._.._ . . . . . . . . . . . . . . . . . . . . . . . .
Date: ............................................................................................................................................................
Signature: .....................................................................................................................................................
Comments: .................................................................................................................................................
,..__.......................................................................................,......................................................................
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Please attach an extra sheet of paper for additional notes
Fee: (amount)
Document seen:
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Paid/Gratis