guyana immigration service visa application form - Guyana News ...

GUYANA IMMIGRATION SERVICE VISA APPLICATION FORM
Surname (as in passport):
First and Middle Names:
Other Names (Maiden, Professional, Alias, etc.):
Date of Birth:
Place of Birth:
Nationality:
Passport No.:
(a) Date and Place issued:
(b) Date Passport Expires:
Home Address (in full):
(a) How long have you lived at this address:
(b) Telephone No. :
(c) E-mail address:
Name and address of Employer:
Employer’s Telephone No.:
Present Occupation (if retired, past occupation):
Sex: Male [ ]; Female [ ]
Colour of hair:
Height: (in centimetres)
Colour of eyes:
Complexion:
Marks of Identification:
Marital Status: Married [ ]; Single [ ]; Divorced [ ]; Widowed [ ]; Separated [ ]
Have you ever applied for a Guyana visa before? Yes [ ]; No [ ]
(a) Where?
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GUYANA IMMIGRATION SERVICE VISA APPLICATION FORM
(b) When?
(c) Type of visa: Tourist [ ]; Business [ ]
(d) Was visa issued? Yes [ ]; No [ ]
Who will furnish your financial support?
Where will you stay in Guyana?
Address of your host in Guyana:
What is the purpose of your visit?
Have you ever visited Guyana before? Yes [ ]; No [ ]
Do you intend to work in Guyana? Yes [ ]; No [ ]
If on business, provide name and address of business contact in Guyana:
Have you ever been afflicted with any contagious disease? Yes [ ]; No [ ]
Have you ever been arrested, convicted for any offence or crime: Yes [ ]; No [ ]
Have you ever been subject of a legal pardon or amnesty? Yes [ ]; No [ ]
Have you ever been involved in illegal narcotic activities? Yes [ ]; No [ ]
Have you ever been deported from Guyana within the last five years? Yes [ ]; No [ ]
Have you ever been arrested for illegally trying to obtain a visa? Yes [ ]; No [ ]
When are you due to arrive in Guyana?
How long do you intent to stay in Guyana?
DECLARATION:
I certify that I have read and understood all the above questions and the answers I have given
on this form are true and correct to the best of my knowledge and belief. I understand that
possession of a visa does not entitle the bearer to enter Guyana at port of entry if he/she is
found inadmissible.
Signature of Applicant:
Date:
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GUYANA IMMIGRATION SERVICE VISA APPLICATION FORM
NOTE:
Failure to disclose the true purpose of applying for a visa or the submission of false
information will result in refusal of entry or expulsion from Guyana. A visa application fee of
US$30.00, in the form of a Money Order or bank draft, is required. Persons applying by mail
must add return mailing costs. Personal cheques are not accepted.
Please attach two photographs to this form.
FOR OFFICIAL USE ONLY
Type of Visa: Tourist [ ]; Business [ ]
Valid until...................................................................................................
for *Single/Multiple Entry (*Delete which is not applicable)
Date issued:............................................................................................................
Signature of Consular Officer:................................................................................
[This form is issued by the Embassy of the Republic of Guyana, State of Kuwait]
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