Please Check One

For official use

Visa No:___________________________  Single Entry

Type of Visa:_______________________  Multiple Entry
z
Date of Issue:_______________________  Single Entry (Rush)

Charges:___________________________  Multiple Entry (Rush)

(Pay by bank transfer(swift or rapid).
Issuing Officer:_____________________
Personal checks are not accepted.

Application for United Kingdom Entry Permit/Visa

INSTRUCTIONS:
1. This form must be completed in capital letters and submitted (together with four (2) recent passport-size pictures)
2. The processing period is five (3) business days.
3. Full names and addresses of reference should be stated (including telephone numbers, if available).
4. Any information stated on the form and subsequently found to be incorrect may render entry permit/visa void.
5. Applicants applying should send all document by scanned attachment via e-mail

1. (a) Surname______________________________________ First Name (s)________________________________________

Previous Name (if applicable)___________________________________________________________________________
(b) Date of Birth____________________________________(c) Place of Birth_____________________________________
(d) Nationality______________________________________(e) Former Nationality (if any)__________________________
(f) Passport No._____________________________________(g) Date of Issue_____________________________________
(h) Place of Issue____________________________________(i) Date of Expiry____________________________________

2. Profession/Occupation__________________________________________________________________________________
3. (a) Business Address & Tel. No.__________________________________________________________________________

3. (b) Residential Address & Tel. No._____________________________________________________________________

4. Proposed date of departure for UK______________________________________________________________________

5. (a) Traveling by: Air Sea Land

6. Purpose of Journey: Business Tourism Employment Official Student Transit

7. Name & address of reference:

(i)__________________________________________________________________________________________________
8. If employment, name & address of employer in UK_____________________________________________________
9. Duration of Stay in UK_______________________________________________________________________________
10. Date of last visit to UK______________________________________________________________________________

11. Applicant’s signature_____________________________________ Date of application _____________________________