Passport Size Photograph Of Visa Applicant To Be Affixed Here printable pdf download

Passport size Photograph

JAMAICAN VISA APPLICATION

of Visa Applicant to be

affixed here

1. Last Name (s) …………………………………………………………………….

2. First Name(s)………………………………….…………………..……………………..

Previous names if Applicable…………………..………………………………………………………………………………………………………………………………………………….

Marital Status: Married

Single

Widowed

Divorced

Gender: Male

Female

Date of birth [dd/mm/yyyy] ………../………./……….. Place & Country of Birth ……………………………………….……………………………………………………………………

Present Nationality …………………………………………………………………………… Former Nationality …………………………………..………………………………………..

Passport No# ………………………..…………………… Place & Country of Issue …………………………………..……………………………………………………………………..

Date of Issue [dd/mm/yyyy] .…………../…….……./…………..

Expiry Date [dd/mm/yyyy] ……….…../…..………./…...……..

Please specify the basis of authorization for (re)entry to your country of permanent or temporary residence:

Permanent Residence

Visa

Other ……………………..…………… No# ………………..…… Date of Expiry [dd/mm/yyyy] ……../………./……………….

10. (a) Present Address ……………………………………………………..……………………………………… Country …………………………………………………..………………….

Home Telephone No ………………………………………….. Fax No ………………….…………………. Email ………………………………….………………………………

(b) Permanent Address …………………………………………………………………………………………………….. Country …………………………….……………………………….

11. Occupation ………………………………………………… Business Address & Telephone No ………………………….……………………………………………………………………..

12. Purpose of Visit:

Vacation

Family Visit

Business

Other (Please Specify) ………………….………………………………………

13. Duration of Proposed Visit ……….. …………………………………………..……………………………………………………………………………………………………………………...

14. Dates of Previous Visits ……………………………………………………….………………………………………………………………………………………………………………………..

15. Address in Jamaica …………………………………………….…………………………………………………………………………………………………………………………...

16. Means of support during visit:

Cash

Credit Card

Travellers’’ Cheques

Other (Specify) ……………………………………...

17. Particulars of any minor children (under age 18) accompanying you:

Name ……………………………………………………………………… Date of Birth ………./………../………… Place of Birth ……………………………………………

Name ……………………………………………………………………… Date of Birth ………./………../………… Place of Birth ………………………………….…………

Name ……………………………………………………………………… Date of Birth ………./………../………… Place of Birth ………………………….…………………

18.

Provide the particulars of two (2) References (if any) in Jamaica:

Name………………………………………..……….…………………

Name …………………………………………………………………………………………….

Address …………………………………………………..……………

Address ………………………………………………………………………………………….

…………………………………………………………………………..

…………………………………………………………………………………………………….

Telephone No………………………………………………………….

Telephone No……………………………………………………………………………………

19. I hereby certify that I have read and understood all the questions set out in this application and that all the answers I have furnished on this document are

true and correct to the best of my knowledge. I understand that any false or misleading statement may result in the refusal of a visa or entry to Jamaica.

Signature of Applicant …………………………………………………………………….………………………………

Date ………….……/……………..…/………………………..…

FOR OFFICAL USE ONLY

Visa #

Receipt #

Official Stamp of

Issuing Post to be

Affixed Here

Name of Consular Officer ……………………………….…………………….. Signature …………………………… Date …….…./………/……..…

Jamaican High Commission, London

December 2009